| Objective: At present,growth hormone has been widely used in ovulation induction with low ovarian response,but there is still a lack of a unified regimen of growth hormone medication.This paper aims to explore the factors affecting pregnancy outcome in POR patients who receive growth hormone,and to study the influence of different courses of growth hormone on pregnancy outcome after GN initiation.To provide reference advice for optimizing the use of growth hormone in POR patients,in order to guide the clinical work brtter,to improve the pregnancy outcome of POR patients.Methods: A total of 115 cycles of POR patients who received IVF-ET/ICSI-ET application of growth hormone in the Reproductive Medicine Research Center of the First Affiliated Hospital of Guangxi Medical University from December2018 to December 2019 were selected for retrospective analysis.In the first part,the patients were divided into the pregnant group(38 cases)and the non-pregnant group(77 cases)according to the clinical pregnancy,and the general information and the factors affecting the pregnancy outcome were compared.In the second part,92 patients were divided into GH < 11.5 days(92cases)and GH > 11.5 days(23 cases)according to the days of growth hormone administration.The effects of different growth hormone administration days on pregnancy outcome were compared.In the third part,groups were divided according to age,and the general data and clinical and laboratory indicators of the group < 35 years old(42 cases),35≤ age < 40 years old group(29 cases)and the group ≥40 years old group(44 cases)were compared.Result: In the fresh transplantation cycle of POR patients treated with growth hormone,the number of years of infertility,BMI,b FSH,b LH,AMH,AFC,the days of using Gn\GH,E2 and P of HCG day,number of eggs obtained,number of fertilized eggs,number of optimal embryos,and number of transplanted fertilized eggs in pregnant group and non-pregnant group were analyzed.There was no significant difference in the method of fertilization(IVF/ICSI)(P > 0.05),but there were significant differences in the age(P =0.025),intimal thickness(P=0.011)and induction scheme(P =0.002)in the pregnant group compared with the non-pregnant group.The factors with statistical differences in univariate analysis,including age,intimal thickness,ovulation induction regimen and days of GH application,were analyzed by multivariate binary logistic regression analysis.The results showed that ovulation induction regimen(OR=4.054,P=0.012)was an independent influencing factor for pregnancy outcome of POR patients treated with growth hormone.The results showed that there were no significant differences in age,infertility years,BMI,b FSH,b LH,AMH,AFC,E2 and P of HCG day,number of eggs obtained,number of fertilized eggs and number of embryos in clinical pregnancy between GH < 11.5 and GH > 11.5days(P > 0.05).The endometrial thickness of GH > 11.5 d group was slightly thicker than that of < 11.5 d group(P < 0.05),but the endometrial thickness of GH > 11.5 d group was suitable for embryo implantation and had no clinical significance.The general data,clinical and laboratory indexes of different age groups were compared.The results showed that there were no significant differences in age,infertility years,BMI,b FSH,b LH,AMH,AFC,total amount and days of using Gn\GH,E2 and P of HCG day,endometrial thickness,number of retrieved eggs,number of fertilized eggs and number of excellent embryos among the three groups(P > 0.05).In terms of the clinical pregnancy rate of the three age groups,with the increase of age,the clinical pregnancy rate decreased significantly,the difference was statistically significant(P < 0.05).Conclusion: In POR patients receiving growth hormone(AMH 1.17±0.68ng/ml)fresh cycle transplantation,the ovulation induction regimen was an independent factor affecting the clinical pregnancy,and the traditional long term regimen could still achieve a better pregnancy outcome.When the number of days of growth hormone application after GN initiation was more than 11.5 days,increasing the number of days of growth hormone application could not significantly improve the pregnancy outcome.Clinically,according to the specific conditions of patients,appropriate number of days of growth hormone addition should be selected individually to reduce the economic burden.In POR patients,age is still one of the important factors affecting pregnancy outcome. |
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