The Comparison Of The Clinical Effects Between The Follicular Phae Long-acting Long Protocol And The Luteal Phase Long-acting Long Protocol

Objective:Compare the efficacy of follicular phase long-acting long protocol and luteal phase long-acting long protocol in controlled ovarian stimulation(COS),to provide the basis for the selection and clinical application of the patient's COS program.Methods:A retrospective analysis was the clinical data of 347-cycle patients treated with IVF/ICSI in the reproductive medicine center of the Second People's Hospital of Nanning from August to October 2017.Using the difference in down-pitched time,patients are divided into A and B groups.A group was follicular phase long-acting long protocol(n =170)and B group was luteal phase long-acting long protocol(n=177).The two protocols were divided into three subgroups according to their age:age<30 years:A1 group(n=50)and B1 group(n=40);30?age<35 years:A2 group(n=85)and B2 group(n=89);35?age?38 years:A3 group(n=35)and B3 group(n=48).The comparison of each group is as follows:(1)General conditions:age,infertility years,BMI,bFSH,bLH,bE2,AFC,infertility type composition ratio,fertilization method composition ratio.(2)COS index:Hormone levels after down regulation(FSH,LH,E2),Gn initiation dose,total dose of Gn,days of Gn use,endometrial thicknessand on HCG day,E2 value on HCG day,retrieved oocytes,number of oocytes in MII,number of transplanted embryos,number of transplanted excellent embryos,incidence of moderate-to-severe OHSS,cancellation rate of cycles,Whole embryo freezing cycle rate.(3)Laboratory Indexes and Transplantation outcomes:fertilization rate,cleavage rate,excellent embryo rate,implantation rate,clinical pregnancy rate,ectopic pregnancy Incidence,early abortion rate.Results:1?There were no significant differences in the general conditions(age,infertility years,BMI,bFSH,bLH,bE2,AFC,type of infertility ratio,composition ratio of fertilization)of the two ovulation-promoting regimens in each group(P>0.05).2?In each group,LH levels after down regulation,total dose of Gn in the follicular phase long-acting long protocol were significantly lower than that in luteal phase long-acting long protocol(P<0.05).There was no significant difference in Gn use days,endometrial thickness of HCG day,E2 value of HCG day,number of transplanted embryos,number of transplanted excellent embryos between the two regimens(P>0.05).3?In the follicular phase long-acting long protocol,numbers of obtained oocytes,number of oocytes in MII were significantly higher than those in long-term descending regulation scheme in luteal period(P<0.05);There was no significant difference in the cleavage rate,the incidence of moderate-to-severe OHSS,cycle cancellation rate,Whole embryo freezing cycle rate,implantation rate,clinical pregnancy rate,incidence of ectopic pregnancy rate and early abortion rate between the two protocol(P>0.05).4?Comparison between group A1 and group B1(age<30 years),E2 levels after down regulation from group A1 was lower than group B1(P<0.05),number of oocytes in MII and the rate of excellent Embryos was higher than group B1(P<0.05).5?Comparison between group A3 and group B3(35 ? age ? 38 years),the number of obtained oocytes in the A3 group was higher than that in the B3 group(P<0.05),and the fertilization rate was lower than that of B3 group(p<0.05).Conclution:1?Both the follicular phase long-acting long protocol and the luteal phase long-acting long protocol are effective superovulation regimens,and the follicular phase long-acting long protocol has a tendency to increase clinical pregnancy outcomes.2?compared with the luteal phase long-acting long protocol,the follicular phase long-acting long protocol has the advantages of simple down regulation process,less total dose of Gn and more retrieved oocytes,and easier to be accepted by the patients.