Comparison Of Gnrh-ant Protocol And CC Mild-stimulation Protocol In IVF-ET For Women With Decreased Ovarian Reserve

Objective: To discuss and compare the effects of GnRH-ant protocol and CC(clomipherie citrate)mild-stimulation protocol in IVF-ET for women with decreased ovarian reserve,in order to find a suitable ovulation stimulation protocol.Methods: The clinical data of infertility patients who received IVF-ET treatment were retrospectively analyzed in the Reproductive Medical Center of the Third Affiliated Hospital of Guangxi Medical University from September2016 to December 2018.757 cycles were divided into four groups according to different ages and COS protocols: GnRH-ant group(n=135)and CC group(n=160)whose patients were under 35 years old;GnRH-ant group(n=133)and CC group(n=329)whose patients were over 35 and under 40 years old.The basic condition of patients,ovulation induction effect,laboratory indexes and clinical outcomes of two protocols in different groups above were compared.Results: In groups under 35 years old :the dosage of Gn,the days of Gn,endometrial thickness on HCG day,“A ” type endometria rate on HCG day,the serum E2 level on HCG day,the number of retrieved oocytes,the high-quality embryos rate and cumulative pregnancy rate in CC group were lower than those in GnRH-ant group,and the differences were statistically significant(P<0.05);the serum LH level on HCG day,abnormal fertilization rate and the rate of freeze-all in CC group were higher than those in GnRH-ant group,and the differences were statistically significant(P<0.05).In group over 35 and under 40 years old : the dosage of Gn,the days of Gn,endometrial thickness on HCG day,“A ” type endometria rate on HCG day,the serum E2 level on HCG day and the number of retrieved oocytes in CC group were lower than those in GnRH-ant group,and the differences were statistically significant(P<0.05);the serum LH level on HCG day and the rate of freeze-all in CC group were statistically higher than those in GnRH-ant group(P<0.05).There were no significant differences in the high-quality embryos rate,cumulative pregnancy rate,early abortion rate and cumulative live birth rate between the two groups.(P>0.05).Conclusion:1.For DOR patients under 35 years old,priority should be given to the GnRH-ant protocol.2.For DOR patients over 35 and under 40 years old,the GnRH-ant protocol and the CC mild-stimulation protocol can achieve similar clinical outcomes and each has its own advantages and disadvantages.Individualizedtreatment should be based on specific condition of elderly patients in clinic.