Effect of ratio of follicles in diameter of 16-18 mm on IVF-ET outcomes in PCOS patients on HCG trigger day in antagonist protocols
PENG Lijun
XIE Qijun
YANG Ye
WANG Xinyu
HU Qingyun
LING Xiufeng
Abstract：Objective To explore the effect of ratio of follicles in diameter of 16-18 mm on in vitro fertilization and embryo transfer(IVF-ET)outcomes in polycystic ovary syndrome(PCOS)patients receiving antagonist protocols on human chorionic gonadotropin(HCG)trigger day in antagonist protocols.Methods The clinical data of PCOS patients undergoing IVF-ET assisted pregnancy in Women's Hospital of Nanjing Medical University from January 2016 to December 2021 were retrospectively analyzed.The patients were divided into three groups(group A,group B and group C)according to the ratio of follicles in diameter of 16-18 mum in bilateral ovaries on the HCG trigger day using a tertile method.Group A had a ratio＜0.43(262 cases),and group B had a ratio between 0.43 and 0.56(267 cases),and group C had a ratio≥0.56(247 cases).The general clinical data,ovulation induction cycles,embryo development,first frozen-thawed embryo transfer(FET)outcomes after IVF-ET cycle,and pregnancy and perinatal outcomes were compared among the three groups.Results The values of baseline luteinizing hormone(LH)and baseline LH to baseline follicle-stimulating hormone(FSH)ratio in group B were significantly higher than those in group A and group C(P＜0.05),and the differ-ences were statistically significant(P＜0.05).The total dose of gonadotropin(Gn)in group A was higher than that in group B and group C,and estradiol(E2)level on the HCG trigger day in group A was higher than that in group B and group C,and the differences were statistically significant(P＜0.05).The number of retrieved oocytes,2-pronucleus(PN)embryos,cleavage-stage embryos,and blastocysts,as well as the number of transferable embryos in group B and group C were higher than those in group A,and the differences were statistically significant(P＜0.05).The rate of blastocyst formation in group C was higher than that in group A and group B,and the rate of blastocyst formation with high scores in group C was higher than that in group B,and the differences were statistically significant(P＜0.05).There were no significant differences among the three groups in terms of the number of transferred embryo,the days of transferred embryos,endometrial preparation protocols and endometrial thickness(P＞0.05).There were no significant differences among the three groups in embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate,miscarriage rate,live birth rate,gestational diabetes mellitus incidence and gestational hypertension incidence(P＞0.05).Conclusion In the antagonist protocols,the ratio of follicles in diameter of 16-18 mm on HCG trigger day can reflect the develop-mental potential of oocytes.When the ratio is greater than or equal to 0.56,better retrieved oocytes,2PN embryos,cleavage-stage embryos,blastocyst formation and transferable embryos are achieved,serving as a reference indicator for HCG trigger timing in PCOS patients to a certain extent.However,the ratio does not affect the subsequent first FET pregnancy outcome.
Keywords：Polycystic ovary syndrome(PCOS)In vitro fertilization and embryo transfer(IVF-ET)Follicle diameterHuman chorionic gonadotropin(HCG)trigger timingAntagonist protocol
Publication Date：2024-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 517-522 )