Analysis Of Follicular Phase Long-acting GnRH-a Protocol And GnRH-ant Protocol For Different Infertility Factors In Normal Ovarian Response To Assist Pregnancy Outcome

Objective: To analyze the clinical outcomes of in different infertility populations(endometriosis,unexplained infertility and normal ovarian response to tubal factor infertility)with long-acting long protocols and antagonists in the follicular phase.Methods: The clinical data of patients by IVF/ICSI-assisted conception at the Center for Reproductive Medicine from January 2018 to December 2021 were collected by searching the software database of the Clinical Assisted Reproductive Technology Management System of department of reproductive medicine in The First Affiliated Hospital of Xinjiang Medical University.Patients with endometriosis with 130 cycles,patients with unexplained infertility with 216 cycles and patients with normal ovarian response to tubal factor infertility with 597 cycles of ovulation promotion protocol were divided into follicular Gn RH-a long protocol group and Gn RH-ant protocol group,and dichotomous logistic regression was used to analyze whether ovulation protocol was an independent influencing factor for clinical pregnancy and live birth.Results: the results of the binary logistic multi-factor correlation regression analysis showed that the ovulation promotion regimen was the most important factor affecting the clinical pregnancy and live birth rate of in endometriosis patients.The results of the binary logistic multivariate regression analysis showed that the ovulation promotion regimen was an independent factor influencing the clinical pregnancy and live birth in patients with endometriosis,with a 5.654-fold increase in the chance of clinical pregnancy(OR=6.654,95% CI1.410-31.396,P=0.017)and a 4.841-fold increase in the chance of live birth(OR=5.841,95% CI1.246-27.378,P=0.025)compared with the antagonist regimen.The results of the binary logistic multivariate regression analysis showed no significant correlation between the ovulation protocol and clinical pregnancy and live birth in patients with unexplained infertility.The number of oocytes retrieved,the clinical pregnancy rate of fresh embryo transfer and the live birth rate of fresh embryo transfer were all statistically higher in the follicular phase long regimen than in the antagonist regimen in the normal ovarian response group with tubal factor infertility(P<0.05);Binary logistic multivariate correlation regression analysis revealed a 1.94-fold increase in the chance of clinical pregnancy in the follicular phase long regimen compared with the antagonist regimen(OR=2.940,95% CI 1.727-5.003,P=0.000)and 2.188 times more likely to have a live birth than the antagonist regimen(OR=3.188,95% CI1.745-5.824,P=0.000),while the number of eggs obtained was found to be the number of clinical pregnancies in patients with normal ovarian response to tubal factor infertility(OR=0.822,95% CI 0.723-5.824,P=0.05).95% CI 0.723-0.936,P=0.003)and live births(OR=0.837,95% CI 0.728-0.962,P=0.012)were found to be independently protective factor.Conclusion: Patients with endometriosis and normal ovarian function with tubal factors have more clinical benefit with the follicular phase long-acting regimen than with the antagonist regimen;the use of the antagonist regimen in patients with unexplained infertility not only reduces financial costs but also results in similar clinical pregnancy and live birth outcomes.