Objective To compare the results of a novel regimen of human menopausal gonadotrophin （hMG） in combination with clomiphene citrate （CC） in mid-to-late follicular phase with those of a short protocol of GnRH agoni...Objective To compare the results of a novel regimen of human menopausal gonadotrophin （hMG） in combination with clomiphene citrate （CC） in mid-to-late follicular phase with those of a short protocol of GnRH agonist （GnRHa） and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups： hMG in combination with CC in mid-to-late follicular phase （group A, n=319） and short protocol of GnRHa-hMG （group B, n=523）. The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer （FET） cycles. Results In group A, the serum LH concentration on day 8 -10 was similar with that on the day of hCG administration （2.43 ± 1.92 IU vs 2.51 ±2.05 IU）. The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate （47. 79% vs 48.04%）, the implantation rate （32.49% vs 33.11%） and the cumulative pregnancy rate （58.09% vs 60.22%） were respectively similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrehce of a premature endogenous LH Surge.展开更多
Objective To compare the different ovarian stimulation protocols, clomiphene citrate （CC）, letrozole, human menopausal gonadotropin （hMG） only or combined with CC or letrozole in women undergoing artificial insemi...Objective To compare the different ovarian stimulation protocols, clomiphene citrate （CC）, letrozole, human menopausal gonadotropin （hMG） only or combined with CC or letrozole in women undergoing artificial insemination by donor （AID）. Methods In this prospective clinical trial, 671 couples prepared for AID cycles were randomly allocated to 6 groups according to receive different protocols for the first time, natural cycle （group A, n=l14）, CC （group B, n=lOl）, CC and hMG （group C, n=124）, letrozole （group D, n=97）, letrozole and hMG （group E, n=123） and hMG only （group F, n=l12）. Outcomes including total dose of hMG, duration of hMG therapy, dominant follicles number, endometrial thickness, rates of clinical pregnancy, miscarriage, ovarian hyperstimulation syndrome （OHSS）, multiple pregnancy and can- celation were compared among the 6 groups. Results The total doses and duration of administered hMG were significantly lower in group C and group E than in group F. Dominant follicle number was significantly less in group A and more in group C than in other groups. Endometrial thickness of group B was significantly lower than that of other groups. Clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, OHSS rate and cancelation rate were not statistically different among the stimulation groups. Conclusion AID cycles in which both CC and letrozole had been administered may require shorter duration and a lower total gonadotropin dose, while the clinical out-comes were similar.展开更多
基金supported by National Natural Science Foundation of China (No. 31071275, No. 81270749 and No. 31101070)
文摘Objective To compare the results of a novel regimen of human menopausal gonadotrophin （hMG） in combination with clomiphene citrate （CC） in mid-to-late follicular phase with those of a short protocol of GnRH agonist （GnRHa） and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups： hMG in combination with CC in mid-to-late follicular phase （group A, n=319） and short protocol of GnRHa-hMG （group B, n=523）. The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer （FET） cycles. Results In group A, the serum LH concentration on day 8 -10 was similar with that on the day of hCG administration （2.43 ± 1.92 IU vs 2.51 ±2.05 IU）. The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate （47. 79% vs 48.04%）, the implantation rate （32.49% vs 33.11%） and the cumulative pregnancy rate （58.09% vs 60.22%） were respectively similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrehce of a premature endogenous LH Surge.
基金supported by grants to NSFC(No.8130054881370763)a grant from the Science Foundation of Shanghai Municipal Health Bureau(No.2012454)
文摘Objective To compare the different ovarian stimulation protocols, clomiphene citrate （CC）, letrozole, human menopausal gonadotropin （hMG） only or combined with CC or letrozole in women undergoing artificial insemination by donor （AID）. Methods In this prospective clinical trial, 671 couples prepared for AID cycles were randomly allocated to 6 groups according to receive different protocols for the first time, natural cycle （group A, n=l14）, CC （group B, n=lOl）, CC and hMG （group C, n=124）, letrozole （group D, n=97）, letrozole and hMG （group E, n=123） and hMG only （group F, n=l12）. Outcomes including total dose of hMG, duration of hMG therapy, dominant follicles number, endometrial thickness, rates of clinical pregnancy, miscarriage, ovarian hyperstimulation syndrome （OHSS）, multiple pregnancy and can- celation were compared among the 6 groups. Results The total doses and duration of administered hMG were significantly lower in group C and group E than in group F. Dominant follicle number was significantly less in group A and more in group C than in other groups. Endometrial thickness of group B was significantly lower than that of other groups. Clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, OHSS rate and cancelation rate were not statistically different among the stimulation groups. Conclusion AID cycles in which both CC and letrozole had been administered may require shorter duration and a lower total gonadotropin dose, while the clinical out-comes were similar.
