Comparison Of Three Different Ovulation Induction Schemes In The Clinical Application Of IVF-ET In Patients With Polycystic Ovary Syndrome

Objective:The comparison of three different ovulation induction schemes in controlled superovulation(COH)during in vitro fertilization and embryo transfer(ivf-et)for patients with polycystic ovary syndrome(PCOS)was conducted to provide a basis for the selection of clinical treatment schemes for PCOS patients.Methods:A retrospective analysis was performed on 255 cycles of POCS patients who underwent ivf-et in the reproductive center of hechi people's hospital from July 2017 to October 2019.According to the different ovulation induction schemes of controlled superovulation technique,PCOS patients were divided into a group of 49 ovulation cycles in the early-follicular phase long scheme,a group of 146 ovulation cycles in the long-acting long scheme,and a group of 60 ovulation cycles in the antagonist scheme.COH parameters(Gn days,Gn total,E2 value of HCG days,endometrial thickness,incidence of moderate to severe OHSS)were compared among the three groups under normal circumstances(age,BMI,b FSH,b AMH)without significant differences.Comparison of embryo status(number of eggs obtained,number of mature eggs,number of available embryos,rate of superior embryo);Pregnancy outcomes(clinical pregnancy rate,multiple births rate,miscarriage rate,ectopic pregnancy rate)were compared among the three groups for the clinical effect of COH regimen.Results:(1)Comparison of general conditions among the three groups: There were no statistically significant differences in age,BMI,basal FSH(b FSH),and basal AMH(b AMH)values among the three groups(P>0.05).(2)Comparison of clinical indicators among the three groups: Gn days,Gn total,E2(estrogen)value of HCG days and endometrial thickness were statistically significant(P<0.05);The number of Gn days,Gn total and HCG days in the long prefollicular period group were greater than those in the other two groups(P <0.05);The E2 value of the HCG day in the long prefollicular period group was lower than that in the other two groups(P <0.05);There were no statistically significant differences in Gn days,Gn dosage,E2 value of HCG days and endometrial thickness between the long-acting protocol group and the antagonist group(P >0.05);However,there was no statistical difference between the P value of HCG day and the incidence of moderate to severe OHSS among the three groups(P>0.05).(3)Comparison of laboratory data among the three groups: the number of eggs and the optimal embryo rate of the early-follicular long-duration treatment group were higher than those of the long-duration treatment group and the antagonist treatment group(P <0.05);There were no statistically significant differences in the number of eggs gained and the rate of embryos obtained between the long-action treatment group and the antagonist treatment group(P>0.05);There was no statistical difference in the number of mature eggs and available embryos among the three groups(P>0.05).(4)Comparison of clinical outcome indicators among the three groups: the clinical pregnancy rate of the early-follicular long-duration treatment group was higher than that of the long-duration treatment group and the antagonist treatment group(P <0.05),there was no statistical difference in the clinical pregnancy rate between the long-acting regimen group and the antagonist regimen group(P>0.05).There were no statistically significant differences in multiple pregnancy rate,abortion rate and ectopic pregnancy rate among the three groups(P>0.05).Conclusion:When patients with polycystic ovary syndrome(PCOS)received COH long follicular period regimen,although the dosage and days of Gn were higher than those of long-acting long term regimen and antagonist regimen,the treatment time of the patients wasincreased.However,the optimal embryo rate and clinical pregnancy rate of PCOS patients with long early follicular period regimen were higher than those with long long long-term regimen and antagonist regimen,which improved the pregnancy outcome of PCOS patients.Long prefollicular period is an ideal COH protocol for IVF-ET treatment of PCOS patients.