Analysis Of The Application In Women Of Different Ages With Follicular Phase Long-Acting GnRH-a Protocol

Objective: To evaluate and research the clinical application of controlled superovulation using long-acting follicular phase Gn RH-a protocol in infertile women with normal ovarian function at various ages.Methods: Data were collected on a total of1108 infertile patients who attended the Reproductive Medicine Center of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2021 and underwent controlled superovulation using a long-acting follicular phase protocol.The population included was divided into group A(age <35 years)and group B(age ≥35years)using age 35 years as the cut-off point,and the general clinical data,COH process-related indicators,ovulation promotion outcomes and fresh transplantation cycle outcomes of patients in different age and different ovarian response subgroups were analyzed;the correlation between the assessment of ovarian responsiveness indicators and the number of eggs obtained was studied;binary logistics regression was used to Binary logistic regression was used to screen for factors influencing pregnancy outcomes.Results:The number of eggs obtained,the number of MII eggs,the number of 2PN,the number of mature embryos,the number of transferable embryos,the rate of embryo freezing and the incidence of HOR were higher in group A compared with group B(P<0.05);the differences between the two groups in terms of general clinical information(BMI,AFC and AMH,etc.),clinical outcomes of fresh transfer cycles(clinical pregnancy rate,miscarriage rate and live birth rate,etc.)were not significant(P>0.05).In different age groups,AMH,AFC,FSI,FORT,OSI,HCG day E2,HCG day P,HCG day endometrial thickness,PFC,number of eggs obtained,number of MII eggs,number of 2PN,number of mature embryos,number of transferable embryos,number of good quality embryos,embryo freezing rate,OHSS incidence gradually increased with increasing ovarian responsiveness,and BMI,b FSH/LH and Gn use(starting dose,number of days and total use)gradually decreased;there was no statistically significant difference in BMI,AMH,b FSH/LH and Gn use between the different response groups in group B(P > 0.05),and the difference between clinical outcomes(clinical pregnancy rate,miscarriage rate and live birth rate,etc.)of fresh transfer cycles in the different response groups in both age groups was not significant(P > 0.05).AMH,AFC,OSI,FSI,and FORT were positively correlated with the number of eggs gained;age,BMI,b FSH,and b FSH/LH were negatively correlated with the number of eggs gained,with the largest correlation coefficient being OSI(r=0.870).f SI,FORT,OSI,and HCG day P were independent influences on pregnancy outcomes.Conclusion: Among women with normal ovarian function,there is an excellent clinical pregnancy rate in the long-acting Gn RH-a protocol in follicular phase when choosing the COH protocol,even in older women.In young patients with normal ovarian function with ovarian hyperresponsiveness,the long-acting follicular phase Gn RH-a protocol did not increase the risk of OHSS while having a higher clinical pregnancy rate.OSI,FSI,FORT and HCG day P can be reference indicators for formulating COH individualization schemes and embryo transfer strategies.