Factors affecting clinical pregnancy in controlled ovarian hyperstimulation with GnRH-a long protocol: a retrospective cross-sectional study
Creators: name: Fan, Yanli
name: Sun, Yi-Fei
name: Xu, Yue-Ming
name: Cao, Zi-Yu
name: Luo, Zhuo-Ye
name: Sun, Yong
name: Zhao, Zhi-Ming
name: Hao, Gui-Min
name: Gao, Bu-Lang
Publisher: name: Taylor & Francis
Year: 2022
Subjects: subject: Cell Biology
subject: Chemical Sciences not elsewhere classified
subject: Immunology
subject: FOS: Clinical medicine
subject: Mathematical Sciences not elsewhere classified
subject: Developmental Biology
subject: Science Policy

description: This retrospective cross-sectional study was to investigate factors affecting clinical pregnancy in patients who received gonadotropin-releasing hormone agonist luteal phase long protocol (GnRH-a long protocol) and underwent fresh <i>in-vitro</i> fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) embryo transfer cycle. One thousand five hundred and twenty-five patients who received GnRH-a long protocol and underwent fresh IVF/ICSI embryo transfer cycle were enrolled. The clinical pregnancy rate (63.1 <i>vs.</i> 22.4%, <i>p</i> &lt; .05) and live birth rate (53.8 <i>vs.</i> 14.5%, <i>p</i> &lt; .05) were significantly higher while the miscarriage rate (12.5 <i>vs.</i> 35.3%, <i>p</i> &lt; .05) was significantly lower in the two embryo group than those in the one embryo group. The clinical pregnancy rate (48.5 <i>vs.</i> 64.1%, <i>p</i> &lt; .05) and live birth rate (38.4 <i>vs.</i> 55.0%, <i>p</i> &lt; .05) were significantly lower in patients older than 33.5 years than those in younger patients. The clinical pregnancy rate (52 and 60.6 <i>vs.</i> 79.7%, <i>p</i> &lt; .05) and live birth rate (36 and 51.4 <i>vs.</i> 69.6%, <i>p</i> &lt; .05) of the thin and mediate groups were significantly lower than those in the thick group, whereas the ectopic pregnancy rate (11.5 and 1.9 <i>vs.</i> 0%, <i>p</i> &lt; .05) was significantly higher in the thin group than in the mediate and thick group. Multivariate logistic regression analysis showed that age (OR = 0.956, 95% CI [0.931, 0.982], <i>p</i> &lt; .05), number of embryos transferred (OR = 2.491, 95% CI [1.670, 3.715], <i>p</i> &lt; .05) and endometrial thickness on the transplantation day (OR = 1.124, 95% CI [1.067, 1.185], <i>p</i> &lt; .05) were independent factors significantly associated with clinical pregnancy. In conclusion, endometrial thickness (&gt;14.69 mm) on the day of transfer, two cleavage embryos transferred, and female age (≤33.5 years) are independent factors affecting clinical pregnancy outcomes in controlled ovarian hyperstimulation with GnRH-a long protocol for assisted conception.
IMPACT STATEMENT<b>What is already known on this subject?</b> Fresh embryo transfer cycle with GnRH-a long protocol will result in a higher pregnancy rate in controlled ovarian hyperstimulation cycles.<b>What do the results of this study add?</b> Endometrial thickness on the day of transfer, number of embryos transferred, and female age were independent factors affecting clinical pregnancy outcomes.<b>What are the implications of these findings for clinical practice and/or further research?</b> When performing a fresh IVF/ICSI embryo transfer cycle with GnRH-a long protocol for ovulation induction, the independent affecting factors should be taken into consideration. <b>What is already known on this subject?</b> Fresh embryo transfer cycle with GnRH-a long protocol will result in a higher pregnancy rate in controlled ovarian hyperstimulation cycles. <b>What do the results of this study add?</b> Endometrial thickness on the day of transfer, number of embryos transferred, and female age were independent factors affecting clinical pregnancy outcomes. <b>What are the implications of these findings for clinical practice and/or further research?</b> When performing a fresh IVF/ICSI embryo transfer cycle with GnRH-a long protocol for ovulation induction, the independent affecting factors should be taken into consideration.