| Popis: |
Background: Due to poor number and quality of oocytes, the reproductive prognosis of diminished ovarian reserve (DOR) patients is obstinately disapproving. This study will compare the effects of double trigger and hCG trigger on the culture outcome and implantation outcome during the IVF treatment for DOR patients. Methods: a total of 857 controlled ovarian stimulation (COS) cycles and 366 frozen embryo transfer (FET) cycles were included in this study. The difference in retrieval cancellation, oocyte retrieval, number of oocytes, maturation oocytes, fertilization, embryos were evaluated between the two groups in the COS dataset, while implantation, clinical pregnancy, ongoing pregnancy, and spontaneous abortion were analyzed based on FET dataset. To robustly evaluate the marginal effect of the study factor as well as other covariates, a cluster-weighted GEE model was exploited to fit the uniqueness of IVF-ET data.Results: Neither the retrieval outcome, nor cultural or implantation outcomes were improved after dual-trigger. The OR values were 1.08 (95% CI: 0.41 ~2.78) for retrieval cancellation, 1.33 (95% CI: 0.89 ~2.00) for oocyte harvest, 0.99 (95%: 0.97 ~1.02) for oocyte maturation, 1.03 (95%CI: 0.94 ~1.12) for fertilization, 1.04 (95%CI: 0.94 ~1.15) for viable embryo, and 1.03 (95%CI: 0.88 ~1.19) for top quality embryo. As to the transfer outcome, no difference was identified between the two groups, with the ORs 0.90 (95%CI: 0.62 ~1.30) for implantation and 0.97 (95%CI: 0.56 ~1.69) for clinical pregnancy. This insignificance remained unchanged after adjusting for the covariates such as age, BMI, infertility duration, etc.Conclusions: Dual triggering the final oocyte maturation combined of GnRH-a and standard dose of hCG cannot significantly improve the retrieval, cultural or implantation outcomes of IVF-ET treatments in women with DOR. |
