Comparison Of The Efficacy And Safety Of Gnrh Antagonist Protocol And GnRH Agonist For Patients With IVF-ET/ICSI

Objective:To compare the ovulation induction effect and clinical outcome of the GnRH antagonist protocol and the GnRH agonist long protocol in IVF-ET/ICSI treatments,the patients who is infertile,and to explore the effectiveness and safety between the two ovarian stimulation protocols.Methods:1.Select 118 cycles of IVF-ET/ICSI in the Reproductive Medicine Center of Loudi Hospital Affiliated to Nanhua University from July 2016 to September 2020 and meet the inclusion and exclusion criteria.Among them,GnRH agonists are short-acting,the 68 cycles of the plan were the long protocol group,and the 50 cycles of the GnRH antagonist protocol were the antagonist group.2.Comparing the general information（age,BMI,AMH）,basal sex hormone（E₂,FSH）serum,Gn usage（Gn start dose,duration of Gn stimulation,total Gn dosage）,and the sex hormone（E₂,P,LH）serum of h CG injection daybetween two groups.3.Laboratory indicators:the comparison between the number of total oocytes,2PN,cleavage,transferable embryos,good-quality embryos,and the rate of 2PN,cleavage,transferable embryos,good-quality embryos.4.Clinical outcome:Clinical outcome:the implantation rate,clinical pregnancy rate,early pregnancy loss rate,birth rate,and live birth rate.5.OHSS situation:freezing the whole embryos to prevent OHSS and the occurrence of severe/extremely severe OHSS.6.The follow-up of pregnancy:Follow-up the pregnancy,birth,live birth,neonatal and the fetus.Results:1.Comparison of general data:the two groups of patients had no significant difference in age,BMI,and AMH（P>0.05）.2.Comparison of basal sex hormones,Gn usage,and h CG injection daily sex hormones:Compared with the long protocol group,duration and dosage in antagonist group were decreased,and the daily LH level of h CG increased,and the difference was statistically significant（P>0.05）,There was no statistically significant difference between the basal FSH,E₂,Gn start dose and h CG day E₂ and P levels of the two groups（P>0.05）.It shows that the duration and total dosage of Gn in the antagonist group decreased,and the LH level on h CG day is higher,and there is no significant difference in the basal E₂,FSH,and h CG day E₂and P levels between the two groups.3.Comparison of laboratory indicators:There was no statistically significant difference in the number of total oocytes,2PN,cleavage,transferable embryos and good-quality embryos between the two groups（P>0.05）.Compared with the long protocol group,the 2PN rate and good-quality embryo rate in the antagonist group increased,and the difference was statistically significant（P>0.05）,and there is no statistical significance in the comparison of the transferable embryo rate and the cleavage rate in the two groups（P>0.05）.4.Comparison of clinical outcomes:There was no statistically significant difference in implantation rate,clinical pregnancy rate,early pregnancy loss rate,birth rate and live birth rate comparison between the two groups（P>0.05）.5.Freezing the embryos to prevent the OHSS occuring and the occurrence of severe/extremely severe OHSS:The 68 stimulation cycles in the long solution group,including 8 cycles of the prevention of OHSS,accounting for 11.76%.antagonist group a total of 50 stimulation cycles Among them,it is 2 cycles for the prevention of OHSS,accounting for 4.00%.The two groups were not severe/extremely severe OHSS in this study.up of pregnancy:（1）The two groups of follow-up rates were 100%,and there were no dead delivery.（2）The long protocol group was born 24 cycles,the birth rate and the lively birth rate were 51.06%.The antagonist protocol group was born 11 cycles,the birth rate and the lively birth rate were 37.93%.（3）The long protocol group gave birth to 30 newborns（male 15and female 15）.The antagonist group gave birth to 12 newborn（male 7and female 5）.（4）There were 1 patient in the long protocol group to develop abortion in 18 weeks,and there was no malformed fetus in the antagonist group.Conclusion:The duration of Gn stimulation of antagonist protocol is short,and required smaller dose of Gn.In addition,it can reduce the risk of OHSS,and the implantation rate and clinical pregnancy rates similar to the long protocol,so it is a more convenient,economical,safe,effective ovarian stimulations,Particularly the patients with high-reaction in ovarian are a safer ovarian stimulation.