Purpose

To compare differences in euploidy rates for blastocysts in preimplantation genetic testing for aneuploidy (PGT-A) cycles after gonadotropin-releasing hormone agonist (GnRH-a) long and short protocols, GnRH-antagonist (GnRH-ant) protocol, progestin-primed ovarian stimulation and mild stimulation protocols, and other ovary stimulation protocols.

Methods

This was a retrospective cohort study from the Assisted Reproductive Medicine Department of Shanghai First Maternity and Infant Hospital. A total of 1657 PGT-A cycles with intracytoplasmic sperm injection after different controlled ovary hyperstimulation protocols were analyzed, and a total of 3154 embryos were biopsied. Differences in euploidy rate per embryo biopsied, embryo euploidy rate per oocyte retrieved and cycle cancellation rate were compared.

Results

For the PGT-A cycles, the euploidy rate per embryo biopsied was lower in the GnRH-ant protocol than in the GnRH-a long protocol (53.26 vs. 58.68%, respectively). Multiple linear regression showed that the GnRH-ant protocol was associated with a lower euploidy rate per embryo biopsied (β = −0.079, p = 0.011). The euploidy rate per embryo biopsied was not affected by total gonadotropin dosage, duration of stimulation and number of oocytes retrieved. The embryo euploidy rate per oocyte retrieved was similar in all protocols and was negatively correlated with the total number of oocytes retrieved (β = −0.003, p = 0.003).

Conclusion

Compared with the GnRH-a long protocol, the GnRH-ant protocol was associated with a lower euploidy rate per embryo biopsied. The total gonadotropin dosage, duration of stimulation and number of oocytes retrieved did not appear to significantly influence euploidy rates.

中文翻译：

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不同受控卵巢刺激（COH）方案中植入前囊胚整倍体的比较

目的

比较促性腺激素释放激素激动剂 (GnRH-a) 长方案和短方案、GnRH 拮抗剂 (GnRH-ant) 方案、孕激素引发卵巢后植入前非整倍体基因检测 (PGT-A) 周期中囊胚整倍性率的差异刺激和轻度刺激方案，以及其他卵巢刺激方案。

方法

这是上海第一妇婴医院辅助生殖医学科的一项回顾性队列研究。分析了不同受控卵巢过度刺激方案后采用胞浆内单精子注射的总共 1657 个 PGT-A 周期，并对总共 3154 个胚胎进行了活检。比较每个胚胎活检的整倍体率、每个卵母细胞检索的胚胎整倍体率和周期取消率的差异。

结果

对于 PGT-A 周期，GnRH-ant 方案中每个胚胎活检的整倍体率低于 GnRH-a 长方案（分别为 53.26% 和 58.68%）。多元线性回归显示，GnRH-ant 方案与每个胚胎活检的整倍体率较低相关（β  = -0.079，p  = 0.011）。每个胚胎活检的整倍体率不受总促性腺激素剂量、刺激持续时间和取出的卵母细胞数量的影响。在所有方案中，每个取卵母细胞的胚胎整倍性率相似，并且与取回卵母细胞总数呈负相关（β  = -0.003，p  = 0.003）。

结论

与 GnRH-a long 方案相比，GnRH-ant 方案与每个胚胎活检的整倍体率较低相关。总促性腺激素剂量、刺激持续时间和取出的卵母细胞数量似乎没有显着影响整倍体率。