A retrospective cohort study on the impact of gonadotropin dose on embryo quality and pregnancy outcome: identification of optimal dose range.

OBJECTIVE

The study investigates the impact of gonadotropin (Gn) dose on embryo quality and pregnancy outcome in patients receiving controlled ovarian stimulation (COS) with antagonist regimen fertility treatment to identify the optimal dose range of Gn.

METHODS

In total, 1854 patients treated for in vitro fertilization (IVF) in a single reproductive medicine center between January 2019 and October 2024 were analyzed retrospectively. Patients were categorized into four groups according to the quartile of Gn dose, and general data, embryo quality, and pregnancy outcomes were compared.

RESULTS

The rates of excellent embryos, single blastocyst transfer, clinical pregnancy, and live births were significantly higher and abortion rates were significantly lower for group 1 than for groups 2, 3, and 4. The rates of blastocyst formation were higher in groups 1 and 2 than in groups 3 and 4. Regression analysis showed that total Gn was an independent risk factor for rates of positive human chorionic gonadotropin (HCG), abortion, and live birth and was negatively correlated with blastocyst formation rate (p < 0.05). Restricted cubic spline (RCS) curve analysis showed a linear relationship for blastocyst formation, HCG positive, and live birth rates (p < 0.05). Increases in Gn above the respective threshold values of 2192.6262, 2395.774, and 1897.138 IU resulted in decreased rates of blastocyst formation, positive HCG, and live birth.

CONCLUSION

Gn dose influences embryo quality and pregnancy outcome during COS. Adjustment of Gn dose may improve IVF outcomes.