New insight to proportion of dominant follicles for HCG trigger timing in aged women

• 作 者: Lin haiyan Li Yu Zhang Qingxue Li Yi
• 机 构: Sun Yat-sen memorial hospital of Sun Yat-sen university
• 出 处: 广东省医学会第七次生殖医学学术会议
• 发表日期: 2017年10期
• 关键词: Proportion of ≧ 18mm/=≧ 10mm follicles GnRH antagonist protocol GnRH agonist lon

　　Objective: The aim of this study was to investigate the different proportion of dominant follicles(≧ 18mm) on HCG day in aged women and explore their impacts on the determining of human chorionic gonadotropin trigger timing and the reproductive outcome.Design: This was a retrospective study.Methods: Aged patients ≧ 40 who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer from Jan.2014 to Dec.2016 were included.There were 243 aged patients completed GnRH agonist long protocol and 128 aged patients completed GnRH antagonist protocol.Based on the proportion of ≧ 18mm/≧ 10mm follicles on the day of HCG administration,the included patients were divided into 3 groups(A:<20%;B ≧20% and ≦ 40%;C >40%).The measurements regarding ovarian stimulation characteristics,fertilization rate,good quality embryo rate,clinical pregnancy rates were compared in three goups.Results: In GnRH agonist long protocol,the mean age was comparable.The number of oocyte retrieved in group A was more than other 2 groups as well as serum mean AMH.There were no statistical difference in normal and abmormal fertilization rate.The clinical pregnancy rate in group C was lower than other 2 groups with no statistical difference(30.88% vs 42.04%,40%;p=0.211).In GnRH antagonist protocol,the mean age and serum AMH as well as baseline FSH were comparable in three groups.There were no statistical difference in the number of oocyte retrieved,normal and abnormal fertilization rate,good quality embryo rate between groups.In the clinical pregnancy rate,group A was significantly higher than other two groups(27.27% vs 9.09%,7.40%;P=0.002).Conclusions: Regarding the proportion of ≧ 18mm/≧ 10mm follicles on HCG day and clinical pregnancy rate,less than 20% is recommended in both GnRH antagonist protocol and GnRH agonist long protocol.