High Live Birth Rate In Women With Hypogonadotropic Hypogonadism After IVF-ET

Objective:To evaluate the outcomes of in vitro fertilization and embryo transfer(IVF-ET)in women with hypogonadotropic hypogonadism(HH).Methods:The retrospective study involved 79 women with HH(HH group)who received the first cycle IVF-ET from Mar.2013 to Jan.2017 in our center,and 270 controls(Con group)with matched age,body mass index(BMI),and normal ovarian reserve who received IVF-ET due to oviduct diseases.The outcomes of IVF-ET were compared between the two groups.In HH Group,menarche came after artificial cycle,Gn(FSH+HMG or HMG)was used to induce ovulation within 3 days after menarche.During the course of monitoring,the amount of Gn was adjusted according to the development of follicles detected by transvaginal ultrasound.The addition of r-LH was determined according to the serum LH(luting Hormone)level.In the Con Group,the long-term Luteal protocol was adopted,Oocytes would be retrieved when the diameter of the dominant follicle was?18 mm.After oocyte retrieval,patients in both groups were given Dydrogesterone Tablets and Progesterone Soft Capsules luteal support.Embryo transfer(ET)was carried out on the 3rd or 5th day after oocyte retrieval.Blood pregnancy test was performed 2 weeks or 12 days after embryo transfer.At 4-5 weeks after embryo transfer,the gestational sac and fetal heart beat were detected by transvaginal ultrasonography.The process of superovulation,laboratory results and clinical outcomes were compared between the two groups.Results:There were no statistical significance in clinical pregnancy rate,live birth rate of fresh or frozen embryo transfer and cumulative pregnancy rate between the two groups.The early abortion rate of fresh embryo transfer(8.82%vs 10.66%),rate of ectopic pregnancy(0%vs 1.4%),and early abortion rate of frozen embryo transfer(0%vs 6.98%)were lower in HH group than in control group,although no statistical significances was obtained due to limited number of samples.The HH group used more dosage of Gn(4163.61 ± 1798.98 vs 1872.55±759.19,P<0.001)and longer Gn stimulation duration(14.28±2.80 vs 11.11±1.90,P<0.001)than the control group.The total dosage,serum LH and other related factors have been adjusted in this study.Conclusion:Women with HH could get high live birth rate and cumulative pregnancy rate after IVF-ET/FET treatment.Their clinical outcomes are comparable to those young women with good ovarian function.