| ObjectiveThe cumulative delivery rate was taken as the main research goal,and the time of reaching live.birth,the elimination rate of cycle,the incidence of moderate and severe ovarian hyperstimulation syndrome((ovarian hyperstimulation syndrome,OHSS),the incidence of premature delivery and the incidence of low birth weight infants were taken as the secondary research objectives.Through the comparison of antagonist regimen and long-term regimen,from the aspects of effectiveness and safety,To explore the clinical application value of antagonist regimen and long regimen in each subgroup of Poseidon classification of low response population of ovary,in order to provide ideas for the formulation of individualized ovulation induction plan of low response population in clinic.Methods:Retrospective analysis of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)assisted pregnancy patients in the Reproductive Medicine Center of one Hospital of Henan Provincial from January 2017 to December 2018,screening Patients who meet the Poseidon low response standard and the ovulation induction program are the antagonist and long programs,are finally included in the 997 cycles according to the inclusion and exclusion criteria,and are divided into the Poseidon I group according to the Poseidon classification criteria(antagonist group:126 Cycle,long regimen group:222 cycles),Poseidon? group(antagonist regimen group:161 cycles,long regimen group:150 cycles),Poseidon? group(antagonist regimen group:93 cycles,long regimen group:60 cycles),Poseidon? group(Antagonist regimen group:117 cycles,long regimen group:68 cycles)The general basic data,laboratory and clinical pregnancy outcomes of the antagonist regimen and the long regimen were compared,among the 4 groups of people.Then multiple logistic regression was used to study the effect of ovulation induction program on outcome variables after adjusting confounding factors.Results:In the Poseidon? group:the antagonist regimen group compared with the long regimen,there was no significant difference in the general data of the two groups,the antagonist regimen group total Gn,Gn days,HCG day E2,egg collection,M?number,2PN number,cleavage The number of embryos available for D3 days,the number of transfers,the time to live birth,the cumulative delivery rate were significantly lower than the long-term group,and the differences between the groups were statistically significant(P<0.05),the cycle cancellation rate,the rate of premature delivery,There was no statistically significant difference in the incidence of singleton preterm birth,the incidence of twin preterm birth,the incidence of low birth weight infants,the incidence of single birth low birth weight infants,the incidence of twin birth low birth weight infants,and the incidence of moderate to severe OHSS(P>0.05).In the Poseidon? group:Compared with the long regimen,there was no significant difference in the general data between the two groups.The total Gn,Gn days,HCG day E2,egg retrieval,M? number,2PN number,cleavage number,and D3 days were acceptable in the antagonist regimen group.The number of embryos used and the cumulative delivery rate were lower than those of the long-term program group,and the differences between the groups were statistically different(P<0.05),the number of transplants,the time to live birth,the rate of cycle cancellation,the incidence of preterm birth,the incidence of single preterm birth There was no statistically significant difference in the incidence of twin preterm births,the incidence of low birth weight infants,the incidence of single birth low birth weight infants,and the incidence of twin birth low birth weight infants(P>0.05),and there were no moderate to severe OHSS occurrences in both groups.In the Poseidon? group:compared with the long regimen,there was no significant difference in the general information between the two groups.The total Gn,Gn days,HCG day E2,egg collection,M? number,2PN number,cleavage number of the antagonist regimen group The number of available embryos in D3 days was lower than that in the long-term group,and the differences between the groups were statistically significant(P<0.05),the number of transplants,cycle cancellation rate,cumulative delivery rate,time to live birth,premature birth rate,single There was no statistically significant difference in the incidence of preterm fetal birth,the incidence of twin premature birth,the incidence of low birth weight infants,and the incidence of twin low birth weight infants(P>0.05).There was no moderate to severe OHSS between the two groups.In the Poseidon ? group:compared with the long regimen,there was no significant difference in the general information between the two groups.The total Gn,Gn days,HCG day E2,egg collection,M? number,2PN number,cleavage number of the antagonist regimen group The number of available embryos on D3 days is lower than that of the long-term group,and the differences between the groups are statistically significant(P<0.05),the number of transplants,the cycle cancellation rate,the cumulative delivery rate,the time to live birth,the incidence of premature birth,There was no statistically significant difference in the incidence of singleton preterm birth,the incidence of twin preterm birth,the incidence of low birth weight infants,and the incidence of twin low birth weight infants(P>0.05).There was no moderate to severe OHSS between the two groups.Multiple logistic regression results:In the low-response population(total data),mixed factors weret adjusted and found that the long-term cumulative delivery rate is significant Better than antagonist regimen(aOR:0.52;95%CI:0.37,0.74;P<0.05),but the antagonist regimen shortened the time to live birth(a?:-31.75;95%CI:-54.23,-9.19;P<0.05).After adjusting the above confounding factors,it was found that the ovulation induction program had no significant effect on the rate of cycle cancellation,the incidence of preterm birth,and the incidence of low birth weight infants(P>0.05).In the Poseidon? group+Poseidon? group,mixed factors were adjusted and found that the long-term cumulative delivery rate is significantly better than the antagonist(aOR:0.44;95%CI:0.28,0.68;P<0.05),but the antagonist regimen shortened the time to live birth(a?:-38.96;95%CI:-70.01,-7.90;P<0.05).After adjusting the above confounding factors,it was found that the ovulation induction program had no significant effect on the rate of cycle cancellation,the incidence of preterm birth,and the incidence of low birth weight infants(P>0.05).In the Poseidon? group+Poseidon? group,mixed factors were adjusted,and found that the ovulation promotion program has a cumulative delivery rate,cycle cancellation rate,There was no significant effect on the incidence of preterm birth,the incidence of low birth weight infants,and the time to live birth(P>0.05).Conclusion:(1)In Poseidon ? and Poseidon ? populations,the long-term clinical outcome is superior to the antagonists,but antagonists protocol shortens the time to live birth;(2)In the population of Poseidon ? and Poseidon ?,the clinical outcomes of the long regimen and the antagonist regimen are similar,and the antagonist regimen is more cost-effective;... |
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