Clomiphene Citrate Combined With Low-dose Gonadotropin(Gn)Protocol In IVF/ICSI Treatment

Objectives:To investigate the clinical effects of clomiphene citrate combined with low-dose gonadotropin(Gn)protocol in those IVF/ICSI patients with normal ovarian function and investigate the application of the protocol in IVF/ICSI patients with recurrent failure.Method:The retrospective analysis was conducted on the IVF/ICSI patients with normal ovarian function in Department of Reproductive Medicine,Jiangsu Provincial People's Hospital from January 1,2013 to June 30,2015.Patients were divided into four groups according to the actual frequency of oocyte retrieved.The experimental groups were treated with the protocol of clomiphene citrate with low dose gonadotropin while the conventional antagonist treatments were provided for control groups.Two groups were comparied in patients' age,body mass index,basal hormones levels,the dosage and duration of Gn used,the number of oocyte retrieved,fertilization rate,high-quality embryo rate,implication rate,accumulative clinical pregnancy rate,abortion rate,delivery rate and OHSS rate.Result:A total of 981 observations in experimental groups and 668 observations in control groups were collected in the completed cycle(Completed cycle refers to an oocyte retrieval cycle,fresh embryo or frozen embryo transfer after delivery of live baby or transplanted embryos have been used up)1.(1)In different control groups(different times of oocyte retrieval),Gn dosage(1490.42 ± 418.94 IU in the first group and 1486.56 ± 422.83 IU in the second group),the number of oocytes retrieved(11.42 ± 5.40 in the first group and 11.03 ± 5.01),the OHSS rates(2.11%in the first group and 1.92%in the second group)were significantly higher than those in the experimental groups(Gn dosage:1155.80 ± 461.78 IU in the first group,1110.82 ± 408.47 IU in the second group,1038.24 ± 844.42 IU in the third group,and 925 ± 399.61 IU in the fourth group;the number of oocytes:7.38 ± 4.49 in the first group,6.88 ± 4.01 in the second group,4.71 ± 2.63 in t the third group,and 4.38± 4.47 in the fourth group;the OHSS rate:0.95%in the first group,0.97%in the second group,0%in the third group and the fourth group),the difference was statistically significant(P<0.05).2.There was no significant difference in age,body mass index,basal hormone,Gn duration,fertilization rate,implantation rate and pregnancy outcome between the experimental group and the control group(P>0.05).There was no significant difference between the experimental group and the control group in implantation rate and cumulative live birth rate(P>0.05).Conclusion:(1)The mild ovarian stimulation with clomiphene citrate(CC)and low-dose gonadotropin(Gn)is a practical and effective protocol for ovulation induction.(2)The mild ovarian stimulation with clomiphene citrate(CC)and low-dose gonadotropin(Gn)protocol remains the preferred ovulation regimen in patients with normal ovarian function and recurrent IVF/ICSI failure.