Repeated superovulation induction after failure in previous IVF-ET cycles with the ultra-long protocol: Analysis of outcomes of clinical pregnancy
WANG Bin
KONG Na
LIU Jing-yu
ZHANG Ning-yuan
ZHU Ying-chun
ZHOU Jian-jun
Abstract：Objective:To analyze the clinical outcomes of repeated superovulation induction in patients with adenomyosis or moderate to severe pelvic endometriosis after failure in previous IVF-ET cycles with the ultra-long protocol.Methods:We retrospectively analyzed the clinical data about 37 patients with adenomyosis or moderate to severe pelvic endometriosis in our center from 2009 to 2013,who underwent repeated IVF-ET after failure in the previous cycles with the ultra-long protocol,namely by injection of 2-6 ampoules of 3.75 mg gonadotropin-releasing hormone agonist (GnRH-a).All the patients met the following requirements:hCG-negative at 14 days after transfer,within 3-7 days after menstruation,and properly down-regulated serum follicle stimulating hormone (FSH) (＜10 mIU/nl),luteinizing hormone (LH) (＜10 mIU/ml),estradiol (E2) (＜30 pg/ml),follicle diameter (＜ 10 mm) and endometrial thickness,and received GnRH (Gonal-F,Serono) for ovulation induction.We compared the clinical and laboratory data and pregnancy outcomes between the first and repeated cycles before and after ovulation induction.Results:The repeated cycles,as compared with previous ones,showed significant increases in the antral follicle count (AFC) on the first day of stimulation (7.55 ± 1.86 vs 6.45 ± 2.5,P ＜ 0.05),number of follicles ≥ 14 mm in diameter on the hCG trigger day (7.81 ± 3.6 vs 5.56 ± 3.68,P＜0.05),levelofE2 ([2362.15 ± 1210.49] vs [1749.22 ± 1 139.44] pg/ml,P＜0.05),andnumbersofoocytesre-trieved (7.51 ± 3.23 vs 4.78 ± 3.41,P ＜0.05) and embryos transferred (2.00 ± 0.33 vs 1.50 ± 0.67,P ＜0.05),exhibited a remarkably reduction in the dose of GnRH ([1 791.65 ± 1 889.41] vs [3 439.56 ± 1 836.53] IU,P ＜ 0.05),and achieved a clinical pregnancy rate of 62.16％.Conclusion:With proper reduction of the FSH,LH and E2 levels and follicle diameter,repeated superovulation induction for IVF-ET can improve the ovarian response and pregnancy outcomes of the patients with adenomyosis or moderate to severe pelvic endometriosis after failure in the previous IVF-ET cycles with the ultra-long protocol.
Keywords：IVF-ETultra-long protocolrepeated superovulationpregnancy outcome
Publication Date：2017-12-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1099-1102 )