Journal of Developmental Medicine(Electronic Version)  2025, Vol. 13 Issue (5): 351-357 DOI: 10.3969/j.issn.2095-5340.2025.05.005 |
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| Influence of different ovulation induction protocols on the time to live birth in elderly women with normal ovarian reserve |
| Feng Hanqi, Han Huimin, Liu Yuan, et al
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(Department of Reproductive Medicine, Obstetrics and Gynecology Division, the Seventh Medical Center of the PLA General Hospital, Beijing 100700, China)
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Abstract 【Abstract】 Objective To compare the time to live birth (TTLB) among antagonist protocol, long protocol, and progestin-primed ovarian stimulation (PPOS) protocol in elderly women with normal ovarian reserve (NOR). Method This study employed a retrospective cohort design to analyze 458 cases of elderly women (age ≥35 years) with NOR who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) at the Seventh Medical Center of the PLA General Hospital between January 2020 and January 2023. A total of 458 oocyte retrieval cycles were included. Based on the ovarianstimulation protocols, the patients were divided into the antagonist protocol group (n=230), the long protocol group (n=120), and PPOS protocol group (n=108). The general information, laboratory indicators and clinical outcomes of the three groups were analyzed. Statistical methods were performed by Kruskal-Wallis rank sum test, One-way analysis of variance, χ
2 test and Cox proportional hazards regression model. Result The gonadotropin (Gn) duration in the antagonist, long, and PPOS protocol groups was 10.00 (9.00, 11.00) d, 11.00 (11.00, 13.00) d, and 10.00 (9.00, 11.00) d, respectively. The total Gn dosage was 2 175.00 (1 800.00, 2 793.75) U, 2 925.00 (2 400.00, 3 487.50) U, and 1 950.00 (1 743.75, 2 700.00) U, respectively. The duration and total dosage of Gn in the long protocol group were significantly higher than those in the other two groups (Z values were 38.601 and 24.432, respectively, both P<0.05). There were no statistically significant differences among the three groups in laboratory indicators such as number of oocytes retrieved, mature oocytes, two pronucleus
(2PN) zygotes, transplantable embryos, and high-quality embryos (all P>0.05). Additionally, there were no significant differences in the cumulative pregnancy rate and cumulative live birth rate among the three groups (all P>0.05). The TTLB in the antagonist protocol group, long protocol group, and PPOS protocol group was 319.94 (305.97, 333.91) days, 327.20 (299.57, 354.91) days, and 370.31 (350.58, 390.03) days, respectively. The TTLB in the antagonist group was significantly shorter than that in the other two groups, with statistically significant differences (both P<0.05). Conclusion For elderly women with NOR, the antagonist protocol, long protocol, and PPOS protocol yield similar clinical outcomes. However, the TTLB of the antagonist protocol is relatively less compared to the other protocols.
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Received: 10 October 2024
Published: 01 October 2025
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