A Modified Ultra-Long Downregulation Protocol Improves Pregnancy Outcomes in High Body Mass Index Patients Undergoing In vitro Fertilization/Intracytoplasmic Sperm Injection Treatment

• 作者: Chen Hui-Jun Gong Fei Li Xiao-Feng Li Yuan Lin Ge Lu Guang-Xiu
• 来源期刊: 生殖与发育医学（英文）
• 关键词: Endometrial Receptivity High Body Mass Index In vitro Fertilization/Intracytoplasmic Sperm Injection Modified Ultra-Long Protocol Pregnancy Outcome
• 年，卷（期）: 2020,（3）
• 所属期刊栏目: Original Article
• 页码范围: 156-162
• 页数: 7页
• 语种: 中文
• DOI: 10.4103/2096-2924.294315

摘要

Objective::Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome. The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pregnancy outcomes of patients with high body mass index (BMI) undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), compared to the long protocol (LP). Methods::We retrospectively analyzed the clinical data of 3,920 infertile patients at the Reproductive and Genetic Hospital of Citic-Xiangya from January 2012 to December 2017 by propensity score matching (PSM). Patients were divided into two groups: modified ultra-LP (MULP) ( n = 1,960) and LP ( n = 1,960). Results::In the MULP group, live birth rate (52.65% vs. 46.79%, P < 0.001, odds ratio [ OR]: 1.784, 95% confidence interval [ CI]: 1.563-2.036), clinical pregnancy rate (62.50% vs. 57.91%, P = 0.003, OR: 1.211, 95% CI: 1.066-1.377), and implantation rate (53.24% vs. 49.65%, P = 0.004, OR: 1.155, 95% CI: 1.048-1.272) were statistically significantly higher than those of the LP group. Moreover, the cycle cancellation rates (12.70% vs. 15.15%, P = 0.027, OR: 0.815, 95% CI: 0.68-0.977), abortion rates (12% vs. 14.8%, P = 0.046, OR: 0.785, 95% CI: 0.619-0.996), and ectopic pregnancy rates (1.06% vs. 2.11%, P = 0.04, OR: 0.497, 95% CI: 0.252-0.98) were lower than those in the LP group. Conclusion::The modified ultra-long downregulation protocol improved the pregnancy outcomes in patients with high BMI undergoing IVF/ICSI treatment, providing a potential option for physicians when deciding an optimized ovary stimulation protocol for high BMI patients.