Young obese patients may benefit from GnRH-a long protocol contributing to higher implantation rate and live birth rate of fresh IVF-ET cycles

Qi Wan; Yue Qian; Ming-Jing Xia; Li Tan; Xing-Yu Lv; Xiang-Qian Meng; Yu-Bin Ding; Zhao-Hui Zhong; Li-Hong Geng

doi:10.1016/j.heliyon.2023.e20016

Young obese patients may benefit from GnRH-a long protocol contributing to higher implantation rate and live birth rate of fresh IVF-ET cycles

Heliyon. 2023 Sep 20;9(10):e20016. doi: 10.1016/j.heliyon.2023.e20016. eCollection 2023 Oct.

Authors

Qi Wan^{1

2

3}, Yue Qian⁴, Ming-Jing Xia¹, Li Tan⁵, Xing-Yu Lv¹, Xiang-Qian Meng¹, Yu-Bin Ding^{6

7}, Zhao-Hui Zhong⁴, Li-Hong Geng¹

Affiliations

¹ Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China.
² Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, China.
³ Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China.
⁴ Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
⁵ The Department of Reproductive Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
⁶ Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.
⁷ Department of Pharmacology, Academician Workstation, Changsha Medical University, Changsha, 410219, China.

Abstract

Introduction: Obesity has detrimental influences on women reproductive health. There is little experience in optimizing controlled ovarian hyperstimulation (COH) protocols to treat Chinese obese patients who are undergoing in vitro fertilization and embryo transfer (IVF-ET) therapy.

Methods: The clinical outcome differences were retrospectively analyzed among obese patients who received gonadotrophin-releasing hormone agonist (GnRH-a), GnRH antagonist (GnRH-ant), micro dose GnRH-a (mGnRH-a) and GnRH-a long protocol in IVF-ET cycle at Chengdu Jinjiang Hospital for Women's and Children's Health from January 2014 to December 2019.

Results: The transplantation rate of the GnRH-a long protocol group (59.1%) was higher than that of the GnRH-ant (25.9%) and mGnRH-a (36.7%) groups. The total live birth rate of the GnRH-a long protocol group (46.2%) was higher than that of the GnRH-a group (25.9%) and GnRH-ant group (40.3%). The total number of frozen embryos in the GnRH-ant group was higher than in the other groups (P < 0.05). After adjusting for confounding factors, the logistic regression analysis showed that the GnRH-a long protocol group had higher probabilities of biochemical pregnancy, clinical pregnancy, and live birth than the GnRH-a protocol group. The Gn dose in the mGnRH-a group was higher than the other three groups. Whether single or twin, there were similar neonatal outcomes among the four groups including premature birth rate, Apgar score, newborn weight, and length.

Conclusion: For young obese patients undergoing IVF-ET, the GnRH-a long protocol for COH gives better pregnancy outcomes.

Keywords: COH protocol; IVF-ET; Obesity; Pregnancy outcome.