The Study On Clinical Application Features And Endometrial Receptivity Gene Expression Profile Of Long Protocol In Follicular Phase And Luteal Phase

The study of clinical application features and outcomes of follicular phase long-acting Gn RH-a long protocol and luteal phase shortacting Gn RH-a long protocolObjectiveTo investigate clinical application features and outcomes of follicular phase long-acting Gn RH-a long protocol and luteal phase short-acting Gn RH-a long protocolMethods6114 cycles of patients undergoing IVF treatment at our reproductive medical center from January 2014 to October 2016 were reviewed by retrospective study.They were divided into A and B groups.Group A: 2705 patients undergoing follicular phase long-acting Gn RH-a long protocol.Group B: 3409 patients undergoing luteal phase short-acting Gn RH-a long protocol.Clinical hormone level characteristics,laboratory indexes,pregnancy outcome of patients between two groups were analyzed.In addition,the blood flow indexes of endometrial and subendometrial were measured for patients undergoing treatment of follicular phase long-acting and short-acting Gn RH-a long protocol from February 9th,2017 to February 28 th,2017.Results1.There was no significant difference in age,duration of infertility,BMI,the number of antral follicles between two groups(P>0.05).The starting dose of Gn in group A were lower than group B,with significant difference(P<0.05).Total dosage of r FSH,dosage of HMG,days and total dosage of Gn in group A was statistically higher than that of group B(P <0.05).E2 and LH on the day-of-HCG in group A were lower than group B,progesterone and the thickness of endometrium on the day-of-HCG in group A were higher than group B(P<0.05).The number of ovarian follicles whose diameter were more than 14 mm or 16 mm in group A were less than group B,the number of middle and small follicle(12-14 mm,14-16mm)in group A were higher than group B.The number of oocytes retrieved,2PN number,2PN cleaved number in group A was significantly higher than group B.The MII number and good quality embryo rate in group A was lower than group B(P<0.05),the implantation rate and clinical pregnancy rate was higher than group B(P<0.05),the first trimester miscarriage and ectopic pregnancy rates were lower than group B(P<0.05).2.We compared the hormone levels on gonadotropins(Gn)start-up day,Gn day4/5,HCG-3,HCG-2,HCG-1,HCG administration day,HCG+1,HCG+2,HCG+5,and found that LH level during controlled ovarian hyperstimulation(COH)in group A lower than group B(P<0.05),E2 level in group A lower than group B(P<0.05,except Gn start-up day),progesterone on Gn day 4/5,HCG-3,HCG-2,HCG-1,HCG+1,HCG +5 in group A were lower than group B,the Gn start-up day,the day-of-HCG,HCG+2 in group A were higher than group B(significance of Gn start-up day and HCG+1 day was not reached,others P<0.05).The endometrial thickness on starting day of Gn,Gn day 4/5,HCG-3 in group B was significantly thicker than group A,The endometrial thickness on days of HCG-2,HCG-1,HCG,HCG+1,HCG+2,HCG+5 in group A were thicker than group B(no significant difference on day of HCG-2?HCG-1,others P<0.05).3.A and B group patients were divided into 6 subgroups according to HCG day progesterone level(ng/ml): <0.9,0.9-1.25,1.25-1.5,1.5-1.75,1.75-2,>2,the result showed the pregnancy rates in group A were higher than group B(no significant difference in 1.75-2 and >2 subgroups,others P<0.05).A and B group patients were divided into 5 subgroups according to HCG day E2 level(pg/ml):...