Due to the injection of gonadotropin releasing hormone agonist (GnRH-a) before controlled ovarian hyperstimulation (COH), the scheme of prolonged early follicular period protocol has obvious advantages in achieving ideal egg number, increasing endometrial receptivity to embryo transfer, inhibiting endogenous luteinizing hormone (LH) peak and reducing cycle cancellation rate. The full dose of long acting GnRH-a was also applied before COH in the mid luteal Hypergrowth program, and the mechanism of its lowering tone was similar. But whether the clinical and perinatal outcome of early follicular hyperlengthening is as effective as that of mid luteal hyperlengthening has not been reported at home and abroad. Moreover, there is a lack of prospective randomized controlled studies.
One injection of 3.75mg GnRHa was injected on the 1st-3rd or 21st-23rd day of menstruation. The level of estradiol (E2), progesterone (P), luteinizing hormone (LH) in peripheral blood and the number of follicles in bilateral ovarian internal sinuses were monitored on the 32nd-38th day after pituitary hyporegulation.Gonadotropin (Gn) will be given after pituitary desensitization. When the diameter of at least two follicles ≥ 18mm or more than three follicles ≥ 17mm, the trigger of human chorionic gonadotropin (hCG) will be given and oocyte will be retrieved. The selective fresh single blastocyst transplantation will be carried out on the 4th-6th day after oocyte retrieval. HCG test at 12nd day after transplatation. Follow-up investigation will given during the pregnancy and perinatal period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
1,150
The whole dose of long acting GnRH-a drug was changed to be injected on day 21st-23rd day of menstruation
The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
Wenzhou, Zhejiang, China
RECRUITINGlive birth rate
live birth rate per transplantation cycle
Time frame: live birth of more than 28 pregnancy weeks
clinical pregnancy rate
fetal heart beat confirmed by transvaginal ultrasound
Time frame: fetal heart beat confirmed by transvaginal ultrasound 26-35 days after embryo transplantation
good quality blastocyst rate
formation rate of more than 4BB Blastocyst
Time frame: The ratio of good quality blastocysts above 4BB degree 4-6 days after oocyte collection
Incidence rate of early on-set severe ovarian hyperstimulation syndrome (OHSS)
Severe ovarian hyperstimulation syndrome according to Golan standard
Time frame: Severe ovarian hyperstimulation syndrome according to Golan standard within 7 days after ovum removal
Early misscarage rate
Transvaginal sonography identified patients with abortion after clinical pregnancy
Time frame: Abortion before 12 pregnancy weeks
Perinatal complications
Perinatal complications of mothers and fetus
Time frame: Incidence rate of mother and child complications from pregnancy to postpartum in 42 days
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