| Purpose:To investigate the effect of early follicular prolong protocol and antagonist protocol on in vitro fertilization-embryo transfer(IVF-ET)in patients with normal ovarian response.Method:The study was divided into two parts.The retrospective cohort analysis and prospective randomized controlled trials were used to analyze the early follicular prolong protocol and antagonist protocol.(1)Retrospective cohort analysis method:3680 cases of infertility patients with normal ovarian response treated by IVF-ET in the hospital from January 2014 to December 2018 were selected,and were divided into early follicles according to different ovulation induction programs.The early follicular prolong protocol group(test group)and the antagonist protocol(control group),including 3592 cases in the experimental group and 88 cases in the control group,were analyzed and compared with the data of hormone levels,ovulation and clinical outcomes in the two groups.(2)Patients who underwent IVF assisted pregnancy in our center from January 20 to January 2019 were selected according to the inclusion and exclusion criteria.After the informed consent was signed,they were divided into experimental groups according to the random number table(n=53).And the control group(n=41),the experimental group was given a early follicular prolong protocol,and the control group was given an antagonist protocol;the data of endometrial changes,hormone levels,ovulation and pregnancy outcomes were compared between the two groups.Research analysis and comparison.Result:(1)Retrospective results showed that 3680 patients with normal ovarian response were divided into the early follicular prolong protocol(test group n=3592)and the antagonist protocol(control group n=88).According to the relevant data,the HCG positive rate(78.3%)was higher than that of the control group(70.4%)and the clinical pregnancy rate(72.1%)was higher than that of the control group(61.6%)(P>0.05).However,the implantation rate(54.6%)was higher than(43.1%),and the early abortion rate(4.3%)was significantly lower than(12.1%)(P<0.05).The endometrial thickness of HCG was increased by 0.66 mm(P<0.05)in the early follicular prolong protocol and the antagonist protocol.Compared with the antagonist group,the early follicular prolong protocol had longer Gn time,larger Gn,more eggs,more embryos,fewer embryos,(P<0.05),and slightly higher risk of OHSS.(P>0.05).(2)A prospective cohort study in 94 patients with normal ovarian response found that the early follicular prolong protocol(n=53)compared with the antagonist protocol(n=41),embryo implantation rate(37/84(44%))ratio(24/69(34.8%)),clinical pregnancy rate(27/43(62.8%))ratio(19/35(54.3%))increased significantly,early abortion rate(1/27)(3.7%))significantly lower than(19/35(15.8%)),(P>0.05).The early follicular prolong protocol and antagonist protocol group had a thickened endometrial thickness of 0.4 mm on HCG,a thickened endometrial thickness of 5 mm on the day of transplantation,and 11.6%and 8.6%of endometrial type A on the transplant day,respectively.Both>0.05).Compared with the antagonist group,the treatment group had a long Gn time and a large total Gn(P<0.05);the number of eggs obtained was small and the number of excellent embryos was small and OHSS risk is slightly higher(P>0.05).Conclusions:(1)The early follicular prolong protocol has better clinical outcomes than the antagonist protocol:high embryo implantation rate,clinical pregnancy rate,and low early abortion rate,which may be due to the early follicular prolong protocol.Endometrial receptivity should be preferred as a patient with normal ovarian function.(2)Compared with the early follicular prolong protocol,the antagonist protocol has a small total amount of Gn and a short Gn time.The number of eggs obtained and the number of excellent embryos are more economical ovulation induction schemes and OHSS risk is slightly lower It may be better to choose FET transplantation Clinical outcome. |
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