Comparisons Of Mild And Short Ovarian Protocol In Diminished Ovarian Response Patients

ObjectiveTo compare the differences in COH,laboratory indicators,abnormal conditions in treatment and clinical outcomes between the short GnRH agonist protocol and the minimal stimulation protocol on DOR patients with similar general conditions in the cycle of IVF-ET/ICSI-ET treatment,and to provide the basis for the diminished ovarian response(DOR)patients to select proper COH protocols.MethodsRetrospectively analysed patients using short GnRH agonist protocol or minimal stimulation protocol to controlled ovarian stimulation from January 2014 to December 2018,which were provided by Qilu hospital of Shandong University.We choose 165 cases who used short GnRH agonist protocol and 192cases who used minimal stimulation protocol based on the lasting standards:the first time with IVF,35 or older,primary or secondary infertility patients,neither sperm donor nor egg donor,no chromosome abnormality in both sexes,FSH)8.5IU/L or FSH/LH>3.6 or AFC number?5.We divided them into two groups;short GnRH-a protocol group(group I)and minimal stimulation protocol group(group II),we matched the two group with the same period according to the age,BMI and the basic FSH level.And we got 150 couples.Then we compared the two groups by their general information(age,infertility duration,BMI,basic FSH level,basic LH level and basic E2 level),the controlled ovarian hyperstimulation(Gn dosage,Gn treating time and the numbers of egg),the laboratory indicators(the numbers of 2PN,portable and high quality embryo,normal fertilization rates,normal cleavage rates,portable and high quality embryo rates),the abnormal conditions in treatment(cancellation rate of controlled ovarian hyperstimulation,no egg cycle rate,abnormal or no fertilization cycle rate,no portal embryo cycle rate and cancellation rate of embryo transfer cycle)and clinical outcomes(biochemical and clinical pregnancy rate,abortion rate and persistent pregnancy rate).Results1.There was no significant difference in the general information between two groups(P>0.05);2.The Gn dosage of group ? was higher than that of group ?(P<0.05);there was no significant difference in Gn treatment time between two groups(P>0.05);the numbers of egg,the numbers of 2PN,the portable and high quality embryo of group I were more than group ?(P<0.05);there were no significant differences in normal fertilization rates,normal cleavage rates,portable and high quality embryo rates between two groups(P>0.05);3.In group ?,the no egg cycle rate and the cancellation rate of embryo transfer cycle were higher than that in group ?(P<0.05);there were no significant differences in cancellation rates of controlled ovarian hyperstimulation,abnormal or no fertilization cycle rates,no portal embryo cycle rates between two groups(P>0.05);In group ?,the main reason of embryo transfer cycle cancellation was no portal embryo(43%),and in group ?,the main reason was no egg(49%);4.there were no significant differences in biochemical and clinical pregnancy rates,abortion rates and persistent pregnancy rates between two groups(P>0.05).Conclusion1.For DOR patients,even though chose minimal stimulation protocols mean less eggs than that of short GnRH-a protocol,there were no differences in the clinical outcome between two groups,so less eggs did not mean worse clinical outcome.2.For DOR patients,chose minimal stimulation protocol could reduce Gn dosage without bad influence on follicle fertilization and the quality of embryo,and this protocol could relieve the pain of patients and reduce the treatment expense.3.The no egg cycle rate of minimal stimulation protocol was higher than that of short GnRH-a protocol,so we should take steps to reduce the exorbitant no egg cycle rate.