Efficacy of follicular phase long-acting gonadotropin-releasing hormone agonist down-regulated long protocol for infertility treatment in polycystic ovary syndrome patients

Abstract

Objective To evaluate the effect of different methods on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with polycystic ovary syndrome (PCOS). Methods This retrospective study examined the outcomes of IVF/ICSI with different down-regulated long protocols in PCOS. All first IVF/ICSI treatment cycles between January 2015 and December 2016 in Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University were analyzed. Patients were recruited, who were treated with follicular phase long-acting gonadotropin-releasing hormone agonist (GnRH-a) down-regulated long protocol as study group (n=851) and luteal phase short-acting Triptorelin down-regulated long protocol as control group (n=632). The pregnancy outcomes were analyzed. Results The basal line in age, body mass index (BMI), cycle cancellation rate of ovarian hyperstimulation syndrome (OHSS), average number of transplanted embryos were comparable in the two groups. Total dosage and duration of gonadotropin (Gn) used, endometrial thickness and estradiol level on the human chorionic gonadotropin (hCG) trigger day in study group were higher than those in control group, while the number of the oocyte retrieval and transplantable embryos was lower than that in control group, the differences were statistically significant (P<0.01). In study group, the clinical pregnancy rate (76.17%) and the live birth rate [34.43% (95% CI=31.24%-37.62%)] were higher than those in control group [59.26%, P<0.01; 24.68% (95% CI=21.32%-28.05%), P<0.01]. But the total cumulative live birth rate was comparable in the two groups [69.21% (95% CI=66.11%-72.31%) vs. 67.88% (95% CI=64.24%-71.52%), P=0.584 3]. When the results were stratified in BMI, the cumulative live birth rate got better outcome in BMI≥25.00 kg/m2 subgroup without statistically significant (P=0.126 5). Conclusion PCOS patients can get better live birth rate and similiar cumulative live birth rate after follicular phase long-acting GnRH-a down-regulated long protocol. Key words: Polycystic ovary syndrome; Fertilization in vitro; Gonadotropin-releasing hormone agonist; Cumulative live birth rate