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已发表论文
促性腺激素释放激素激动剂预处理与卵巢储备功能减退的≥35 岁女性行冻融胚胎移植生殖结局的相关性：一项大型回顾性队列研究
Received 21 September 2025
Accepted for publication 5 December 2025
Published 10 December 2025 Volume 2025:17 Pages 5361—5373
DOI https://doi.org/10.2147/IJWH.S569152
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Yueping Zhou, Zhiqi Liao, Yaxin Guo
Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
Correspondence: Yaxin Guo, Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, People’s Republic of China, Tel +86 13297966986, Email guoyaxin610@163.com
Purpose: This study aimed to assess whether different endometrial preparation regimens—natural cycle (NC), hormone replacement therapy (HRT), and gonadotropin-releasing hormone agonist pretreatment followed by HRT (GnRH-a + HRT)—are associated with differences in reproductive and perinatal outcomes among women with diminished ovarian reserve undergoing frozen embryo transfer (FET), and to evaluate whether age (< 35 vs ≥ 35 years) modifies these associations.
Patients and Methods: A total of 4629 women with DOR, defined as anti-Müllerian hormone (AMH) < 1.2 ng/mL and/or antral follicle count (AFC) < 5, undergoing their first autologous FET between 2016 and 2024. Endometrial preparation protocols included natural cycle (NC), hormone replacement therapy (HRT), or gonadotropin-releasing hormone agonist (GnRH-a) pretreatment followed by HRT. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to adjust for baseline differences.
Results: GnRH-a pretreatment before HRT was associated with improved live birth and clinical pregnancy compared with HRT alone, particularly among older women. No significant differences were observed between natural cycle and HRT. Perinatal outcomes among singleton live births were generally comparable across protocols.
Conclusion: GnRH-a pretreatment before HRT may be beneficial for women with diminished ovarian reserve undergoing FET, particularly in those of advanced maternal age.
Keywords: diminished ovarian reserve, frozen embryo transfer, endometrial preparation, GnRH agonist, pregnancy outcomes
Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
Correspondence: Yaxin Guo, Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei, 430030, People’s Republic of China, Tel +86 13297966986, Email guoyaxin610@163.com
Purpose: This study aimed to assess whether different endometrial preparation regimens—natural cycle (NC), hormone replacement therapy (HRT), and gonadotropin-releasing hormone agonist pretreatment followed by HRT (GnRH-a + HRT)—are associated with differences in reproductive and perinatal outcomes among women with diminished ovarian reserve undergoing frozen embryo transfer (FET), and to evaluate whether age (< 35 vs ≥ 35 years) modifies these associations.
Patients and Methods: A total of 4629 women with DOR, defined as anti-Müllerian hormone (AMH) < 1.2 ng/mL and/or antral follicle count (AFC) < 5, undergoing their first autologous FET between 2016 and 2024. Endometrial preparation protocols included natural cycle (NC), hormone replacement therapy (HRT), or gonadotropin-releasing hormone agonist (GnRH-a) pretreatment followed by HRT. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to adjust for baseline differences.
Results: GnRH-a pretreatment before HRT was associated with improved live birth and clinical pregnancy compared with HRT alone, particularly among older women. No significant differences were observed between natural cycle and HRT. Perinatal outcomes among singleton live births were generally comparable across protocols.
Conclusion: GnRH-a pretreatment before HRT may be beneficial for women with diminished ovarian reserve undergoing FET, particularly in those of advanced maternal age.
Keywords: diminished ovarian reserve, frozen embryo transfer, endometrial preparation, GnRH agonist, pregnancy outcomes