Research question

Can premature luteinization of granulosa cells (PLGC) act as a novel parameter of premature luteinization and affect IVF outcomes?

Study design

In this retrospective cohort study, infertile patients undergoing fresh IVF cycles between January 2006 and December 2016 at the Reproductive Medicine Center in Tongji Hospital were included. A total of 42,468 cycles were conducted. Propensity score matching was carried out to match the baseline characteristics, and participants were assigned to the PLGC group and control group. The main outcomes were pregnancy rate and live birth rate.

Results

Patient characteristics and clinical outcomes were compared before and after matching. In general, the fate of oocytes in the PLGC group was much worse than those in the control group after matching, including metaphase II rate, two-pronuclei rate, available embryo rate, blastocyst formation rate, high-quality blastocyst rate, pregnancy rate, implantation rate and live birth rate. Among those potential risk factors, gonadotrophin duration, oestradiol and progesterone on HCG day were positively associated with the occurrence of PLGC in the multivariate logistic regression model, with gonadotrophin dosage negatively related. Moreover, cumulus–oocyte complexes with PLGC showed a high correlation with elevated progesterone levels over 1.5 ng/ml.

Conclusions

Our findings demonstrated the adverse effect of PLGC on oocyte competency. In evaluating cumulus–oocyte complexes, PLGC provide an available novel parameter for premature luteinization judgement in clinical and individualized precise treatment. Close monitoring of progesterone level as well as critical analysis of progesterone elevation can reduce the occurrence of premature luteinization.

中文翻译：

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过早黄体化的新评估参数与试管婴儿结果之间的关系

研究问题

颗粒细胞过早黄体化 (PLGC) 能否作为过早黄体化的新参数并影响 IVF 结果？

学习规划

在这项回顾性队列研究中，纳入了 2006 年 1 月至 2016 年 12 月在同济医院生殖医学中心接受新试管婴儿周期的不孕患者。总共进行了 42,468 个循环。进行倾向评分匹配以匹配基线特征，并将参与者分配到PLGC组和对照组。主要结果是妊娠率和活产率。

结果

比较匹配前后的患者特征和临床结果。总体而言，PLGC组卵母细胞匹配后的命运远低于对照组，包括中期II率、二原核率、可用胚胎率、囊胚形成率、优质囊胚率、妊娠率、着床率和活产率。在这些潜在的危险因素中，在多变量逻辑回归模型中，促性腺激素持续时间、HCG 日雌二醇和孕酮与 PLGC 的发生呈正相关，与促性腺激素剂量呈负相关。此外，具有 PLGC 的卵丘 - 卵母细胞复合物显示出与高于 1.5 ng/ml 的孕酮水平升高的高度相关性。

结论

我们的研究结果证明了 PLGC 对卵母细胞能力的不利影响。在评估卵丘-卵母细胞复合物时，PLGC 为临床和个体化精确治疗中的过早黄体化判断提供了一个可用的新参数。密切监测孕酮水平以及对孕酮升高的关键分析可以减少过早黄体化的发生。