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Effects of estradiol pretreatment at luteal phase on outcome of in vitro fertilization and embryo transfer treatment of antagonist protocol for patients with poor ovarian responder

LU Xiang, XI Ji, JIANG Shan, SUN Ying, WU Zheng-mu, CHENG Wei-wei   

  1. Department of Reproductive Medicine,International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2016-02-28 Published:2016-03-29

Abstract:

Objective To explore the effects of estradiol pretreatment at the luteal phase on the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment of antagonist protocol for patients with poor ovarian responder. Methods Data of 173 patients with poor ovarian response who have underwent IVF-ET treatment were retrospectively analyzed. Patients were divided into the pretreatment group (n=96) and non-pretreatment group (n=77) according to whether the estradiol pretreatment (oral administration with 17 β-estradiol for 4 mg/d at the luteal phase till the second day of menstrual cycle) were conducted before super ovulation induction. General information and indexes relevant to the outcome of IVF-ET treatment of two groups were compared. Results The differences of age (P=0.857), BMI (P=0.727), basal serum FSH (P=0.926)/LH (P=0.579)/E2 value (P=0.898), basal antral follicle count (AFC) (P=0.662), endometrial thickness (P=0.542) and the number of embryos transferred (P=0.321) on transfer day between the two groups were not statistically significant. Compared with the non-pretreatment group, blood FSH (P=0.000) and LH (P=0.019) levels of the pretreatment group before super ovulation induction significantly decreased, mean antral follicle sizes significantly decreased (P=0.000), the total amount of gonadotropin (P=0.001) and stimulation period (P=0.001) significantly increased, and HCG daily E2 (P=0.000) and LH level (P=0.000) increased. The number of retrieved oocytes (P=0.001) and obtained embryos (P=0.005) of the pretreatment group was larger than that of the non-pretreatment group, while the differences of fertilization rate (P=0.648), high-quality embryo rate (P=0.172), implantation rate (P=0.845), clinical pregnancy rate (P=0.948), and continued pregnancy rate (P=0.899) between two groups were not statistically significant. Conclusion Estradiol pretreatment at the luteal phase can increase the number of retrieved oocytes and obtained embryos during the IVF-ET treatment of antagonist protocol for patients with poor ovarian responder.

Key words: estradiol pretreatment, poor ovarian responder, GnRH antagonist, in vitro fertilization