Clinical Effect Of Ovulation Promotion In Patients With Poor Ovarian Response

Objective: To compare the effects of 4 pro-ovulation regimens in poor ovarian response(POR).Methods: Retrospective analysis of 661 ovulation promotion cycles in POR patients undergoing in vitro fertilization/oocyte intracytoplasmic single sperm microinjection(IVF/ICSI)-embryo transfer technique from January 2015 to December 2018 in our hospital.According to the pro-ovulation regimen,it was divided into 4 groups:403micro-stimulation regimen group,125 antagonist regimen group,87 luteal phase regimen group and 46 PPOS regimen group.The results of ovulation promotion,laboratory related indexes and clinical pregnancy outcomes were compared in 4 groups.Results: Ovulation induction: The dosage of Gn in the luteal phase group was higher than that in the other 3 groups(P <0.05).The antagonist regimen group failed to inhibit the early onset LH peak,and the HCG-day LH value was higher than that of the other 3groups(P <0.05).Embryo acquisition:The total number of embryo obtained per cycle was statistically significant(P <0.05),of which the number of embryo obtained in the microstimulus group was less than that in the other three groups(P <0.05),followed by the antagonist group.There was no statistically significant difference between the four groups in the cleavage rate、high qualified embryo rate and the blastocyst formation rate(P>0.05),the optimal embryo rate and blastocyst formation rate of the antagonist scheme were the lowest.Pregnancy outcomes: There was no significant difference in the overall comparison of implantation rate,clinical pregnancy rate and live birth rate in the 4groups(P >0.05),among which the clinical pregnancy rate in the PPOS regimen group was the highest,and the difference between the two pairs was statistically significant compared with the antagonist regimen group(P <0.05).The overall difference of biochemical pregnancy rate and abortion rate in the 4 groups was statistically significant(P <0.05),the biochemical pregnancy rate in the antagonist group was higher than that in the other 3 groups(P <0.05),and the abortion rate in the luteal phase group was higher than that in the other 3 groups(P <0.05).Conclusion: POR patients’ embryos may have low response to antagonist regimen,which failed to inhibit early onset LH peak formation,whether the effect on embryo quality and quantity in POR patients needs further exploration.The PPOS program enables POR patients to obtain the most ideal pregnancy outcome,its ovulation promotion time is flexible,the cost-effective value for clinical promotion,more suitable for POR patients.