| Objective: To investigate the relationship between the ratio of ovarian stimulation duration to original follicular phase length and In Vitro Fertilization outcomes.Methods: From January 2015 to October 2020 in shengjing hospital affiliated to China medical university reproductive medicine center for the first time in vitro fertilization embryo transfer of 6110 women,collect patient age,body mass index(Body mass index,BMI),education,ethnic,menstrual history,clinical diagnosis,history of smoking history,birth history,ovulation,ovulation starting dose,total dose,total eggs,total mature eggs,fertilized egg number,fertilization blastocysts number,embryo quality,pregnancy and live birth clinical information.Based on the statistical analysis of the above data,the quartile method according to OS / FP,and after correcting the age,BMI,and Anti-Mullerian hormone(AMH),the influence of OS / FP on egg acquisition number,fertilization rate,embryo quantity and quality,clinical pregnancy rate,live birth rate,and abortion rate.The odds ratio(Odds ratio,OR)or relative risk(Relative risk,RR)were estimated for each quartile using the lowest quartile array as a control group,and subgroup analysis by age and ovarian stimulation protocol.Results: There were no differences between the four groups in age,BMI,birth history,education,smoking,age at menarche,etiology of infertility and mode of fertilization.The higher AMH level in the OS / FP <0.57 group was(4.1 ± 2.8,p <0.001),and the menstrual cycle duration(30.5 ± 1.8,p <0.001)was also longer(p <0.001).0.67 with the Gn RH-a <0.77 and OS / FP 0.77(58.4%;65.9%,p <0.001).The starting dose of gonadotropin(225.2 ± 53.6IU),total dose of gonadotropin(1885.1 ± 602.1IU),and duration of ovarian stimulation(8.3 ± 1.3 days)in the OS / FP <0.57 group were less than the OS / FP 0.77 group(p <0.001).OS / FP had a significant effect on the number of eggs obtained,mature eggs,fertilization rate,and the rate of superior blastocyst formation.The 0.67 OS / FP <0.77 group had the highest number of eggs and the highest number of mature oocytes(corrected RR=1.11,95% CI interval(Confidence interval,CI): 1.08-1.13,p <0.001;corrected RR=1.13,95% CI: 1.111.16,p <0.001).In the stratified analysis of age and ovarian stimulation protocol,OS / FP had a significant effect on both the number of eggs obtained and the number of mature oocytes in women of different ages and ovarian stimulation types(p <0.001).The highest fertilization rate was observed in the 0.67 OS /FP <0.77 group(corrected OR = 1.11,95% CI: 1.05-1.17,p <0.01).In the age-stratified analysis,the effect of OS / FP on fertilization rate was mainly seen in women aged 30-35and> 35 years(adjusted OR = 1.11,95%CI: 1.011.20,p=0.022;adjusted OR =1.27,95%CI: 1.10-1.48,p= 0.001).Moreover,the effect of OS / FP on fertilization rate was mainly seen in the long protocol.The high-quality embryo rate in the OS / FP> 0.77 group was lower than in the OS / FP <0.57 group(corrected OR = 0.90,95%CI: 0.820.98,p=0.013)and was only present in women aged 30 – 35 years.There was no significant difference in the blastocyst formation rate between the four groups.With OS / FP> 0.77,the lowest superior embryo blast formation rate was observed(corrected OR = 0.81,95%CI: 0.710.93,p <0.01),which was mainly found in women aged 30 – 35 years.No statistically significant effect of OS / FP on pregnancy rate,live birth rate and abortion rate.Conclusion: OS / FP had significant effects on oocyte number,fertilization rate and high quality blastocyst formation rate.When the length of menstrual cycle can be used to predict the length of ovulation induction,and the ratio of ovarian stimulation time to follicular stage duration is within the range of 0.67～0.77,in vitro fertilization and embryo transfer may obtain better outcomes,which can provide important basis and important basis for clinical determination of personalized trigger time. |
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