Archives of gynecology and obstetrics · 2025
Comparative analysis of hCG and dual-trigger protocols in IVF for advanced maternal age women: a single‑center retrospective cohort study based on propensity score matching.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Yuan Minghui, Lv Xuemei, Yuan Yuying, Ju Wenhan, Song Jingyan, Pang Conghui, Zhao Shuai, Chen Wen, Lian Fang, Wu Zhijuan
Аннотация
PURPOSE: This study aimed to compare the efficacy of human chorionic gonadotropin (hCG) and dual-trigger (gonadotropin-releasing hormone agonist [GnRH-a] and hCG) protocols in terms of cumulative live birth rate (CLBR) and other pregnancy outcomes among advanced-age women.
METHODS: We enrolled 801 women aged ≥ 35 years who were experiencing infertility and beginning their first in vitro fertilization cycle at a tertiary academic medical institution between August 2015 and June 2023. Among these, 115 and 686 women used the dual-trigger and hCG methods. Propensity score matching was employed to account for confounding variables. The main outcomes evaluated were CLBR and time to live birth (TTLB).
RESULTS: The CLBR did not differ significantly between the hCG and dual-trigger groups (29.86% vs. 26.09%, P = 0.44), whereas the TTLBs of both groups were similar (9.60 vs. 10.14 months, P = 0.72). CLBR results were similar for both groups, according to a Kaplan-Meier analysis (hazard ratio [HR] = 0.95; 95% confidence interval [CI] 0.63-1.43; P = 0.82). After a multiple Cox proportional hazards model was established, the CLBR of the hCG group remained comparable with that of the dual-trigger group (HR = 0.83; 95% CI 0.53-4.11; P = 0.39). The subgroup analysis also showed similar findings.
CONCLUSION: Considering the higher fertilization rate and shorter TTLB, the dual-trigger protocol may be more suitable than the hCG trigger protocol.
METHODS: We enrolled 801 women aged ≥ 35 years who were experiencing infertility and beginning their first in vitro fertilization cycle at a tertiary academic medical institution between August 2015 and June 2023. Among these, 115 and 686 women used the dual-trigger and hCG methods. Propensity score matching was employed to account for confounding variables. The main outcomes evaluated were CLBR and time to live birth (TTLB).
RESULTS: The CLBR did not differ significantly between the hCG and dual-trigger groups (29.86% vs. 26.09%, P = 0.44), whereas the TTLBs of both groups were similar (9.60 vs. 10.14 months, P = 0.72). CLBR results were similar for both groups, according to a Kaplan-Meier analysis (hazard ratio [HR] = 0.95; 95% confidence interval [CI] 0.63-1.43; P = 0.82). After a multiple Cox proportional hazards model was established, the CLBR of the hCG group remained comparable with that of the dual-trigger group (HR = 0.83; 95% CI 0.53-4.11; P = 0.39). The subgroup analysis also showed similar findings.
CONCLUSION: Considering the higher fertilization rate and shorter TTLB, the dual-trigger protocol may be more suitable than the hCG trigger protocol.