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