The effect of luteinizing hormone changes in GnRH antagonist protocol on the outcome of controlled ovarian hyperstimulation and embryo transfer

The effect of luteinizing hormone changes in GnRH antagonist protocol on the outcome of controlled ovarian hyperstimulation and embryo transfer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The effect of luteinizing hormone changes in GnRH antagonist protocol on the outcome of controlled ovarian hyperstimulation and embryo transfer Zhou Jing-shuang, Chen Jian-hong, Tang Fei-fei, Ou Jian-ping, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2529757/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To investigate the effect of LH level changes on the outcomes of controlled ovarian hyperstimulation (COH) and embryo transfer (ET) in gonadotropin-releasing hormone antagonist (GnRH-ant) protocol. Methods: A total of 721 patients undergoing GnRH-ant protocol COH for the first IVF/ICSI cycles were retrospectively analyzed. COH process were divided into 2 stages, before (stage 1) and after (stage 2) the GnRH-ant initiation, and each with 5 groups basing on LH levels: LH decreased more than 50% (A1, A2), decreased 25%-50% (B1, B2), change less than 25% (C1, C2), increased 25%-50% (D1, D2), and increased more than 50% (E1, E2). Results: There were no significant differences among groups of stage1 regarding COH and ET outcomes. For stage 2, the more obvious the decrease of LH level, the more the number of oocytes retrieved, mature oocytes, fertilized oocytes, embryos cleavaged and the numbers of embryo available (P < 0.05), but without significant differences regarding ET outcomes. We also found the freeze-all rate in Group A2 was higher (P < 0.001). Conclusion: LH level changes before GnRH-ant addition were not related to COH and ET outcomes. LH level changes after the addition of GnRH-ant were related to the outcome of COH, and no significant differences were found relating to ET outcomes. gonadotropin-releasing hormone antagonist protocol controlled ovarian hyperstimulation fresh embryo transfer LH level Figures Figure 1 Introduction Luteinizing hormone (LH) is a glycoprotein hormone secreted by the gonadotropin cells of the anterior pituitary gland, which plays an important role in hormone generation, ovulation promotion and luteinization 1 . Gonadotropin-releasing hormone antagonist (GnRH-ant) protocol has been widely used in assisted reproduction in recent years due to its advantages of non-flare up effect, rapidly and effectively inhibiting the LH surge, reduction of ovarian hyperstimulation syndrome (OHSS) incidence and short treatment period 2 。LH level changes diversitily during COH, most LH levels spontaneously decrease before the administration of antagonist, while about 1/3 LH levels increased, and there are differences in LH level changes between before and after the administration of antagonist 3 . Excessive or insufficient LH levels as well as significant rise or decrease of LH levels will reduce the clinical pregnancy rate 4 – 6 . While the LH level decreased achieved better COH outcomes than increased ones 7 . Meanwhile, there was no difference in clinical outcomes with different LH levels or LH level changes in similar articles 8 – 10 . Up to date, there is no unified conclusion on the effect of LH level changes on COH and fresh ET outcomes in GnRH-ant protocol. Most of published studies have focused on the significant changes of LH level at a single time point, here we study the LH level changes before and after the initiation of antagonist during COH. The purpose of this study was to explore the effect of LH level changes on COH and ET outcomes. Materials And Methods A retrospective study was performed, analyzing data from 721 the first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles performed at Center for Reproductive Medicine, The Third Affiliated Hospital, Sun Yat-sen University (China, Guangdong) during the year 2019. The research steps are shown in the Fig. 1 . The study was approved by the Ethics Committee Review Board of The Third Affiliated Hospital, Sun Yat-sen University (No: [2021]02-246-01). Inclusion Criteria Patients who underwent ovarian stimulation with GnRH-ant (ganirelix [Ganirest®, 0.25 mg; MSD] or cetrorelix [Cetrotide®, 0.25 mg; Merck]) protocol to suppress the pituitary and patient with age ≥ 20 years old and ≤ 45 years old were enrolled in this study. Exclusion Criteria Patients who underwent ovarian stimulation with non-GnRH antagonist protocol, patients with history of hydrosalpinx, uterine malformation and uterine adhesions, endometriosis, endometrial polyps and other diseases or a concurrent medical condition that have to cancel oocyte retrieval were excluded in this study. Protocol GnRH-ant protocol was applied in this study. COH began on day 2 or 3 of a menstrual period with initial injections of 150–300IU of gonadotropin (Gn) (Gonal F, 450IU; Merck/ Follistim, 300IU; MSD). Antagonist ganirelix, (Ganirest, 0.25 mg; MSD) or cetrorelix (Cetrotide, 0.25 mg; Merck) was administered 4 days later according to fixed GnRH antagonist protocol. Recombinant human chorionic gonadotropin (rhCG) (Ovitrelle, 250 ug; Merck) or human chorionic gonadotropin (hCG, 10000IU; Lizhu Pharmaceuticals) was administered once when three leading follicles reached ≥ 17 mm mean diameter or one leading follicle reached ≥ 18 mm mean diameter were observed, oocyte retrieval was performed 34–36 h later. Blood samples were taken to measure hormone levels (FSH, LH, E2, P) on day 1 of ovarian stimulation (day 2–3 of menstrual cycle), day 1 of the antagonist injection (day 6–7 of menstrual cycle) and trigger day, meanwhile B-ultrasounds were performed for follicular size and number. After oocyte retrieval, IVF or ICSI was routinely performed and embryo culture was performed after fertilization. COH process were divided into 2 stages, before (stage 1) and after (stage 2) the GnRH-ant initiation, and each with 5 groups basing on LH levels: LH decreased more than 50% (A1, A2), decreased 25%-50% (B1, B2), change less than 25% (C1, C2), increased 25%-50% (D1, D2), and increased more than 50% (E1, E2). Statistical analysis Continuous variables were presented as means ± SD, categorical variables were presented as percentage. For quantitative data, Kruskal - Wallis tests were used for statistical analysis, while for qualitative data, Fisher's Exact test or Chi-Square test was used for statistical analysis. The significance of all statistical results was set at P < 0.05, and statistical analysis was performed using SPSS software (SPSS Version 25.0.0.0, IBM Corp., USA). Results The effect of LH level changes before the initiation of GnRH-ant on the outcome of COH and ET (Table 1 ). Table 1 LH level changes before administration of GnRH-ant A1 B1 C1 D1 E1 P value No. of patients 395 179 99 19 29 Baseline characteristics Age(years) 31.4 ± 4.9 31.3 ± 4.7 31.5 ± 5.0 30.8 ± 4.4 30.5 ± 4.9 0.902 Body mass index (kg/m 2) 21.4 ± 3.0 21.7 ± 3.1 21.8 ± 2.7 21.7 ± 2.3 22.3 ± 3.4 0.531 Duration of fertility (years) 3.4 ± 2.6 3.4 ± 2.6 3.7 ± 2.6 4.3 ± 1.6 3.8 ± 2.6 0.035 Etiology of infertility (ratio) Primary infertility 190/395 92/179 51/99 11/19 14/29 0.866 Secondary infertility 205/395 87/179 48/99 8/19 15/29 0.866 Female factor 273/395 141/179 77/99 15/19 23/29 0.058 Male factor 106/395 36/179 18/99 2/19 5/29 0.058 Combined 16/395 2/179 4/99 2/19 1/29 0.058 AMH 4.9 ± 3.9 5.4 ± 4.3 6.2 ± 4.7 5.0 ± 4.3 6.7 ± 4.4 0.052 Antral follicular count 13.0 ± 5.9 14.2 ± 6.7 14.3 ± 7.0 12.3 ± 4.7 15.3 ± 6.6 0.147 Ovarian stimulation parameters Duration of stimulation (days) 8.7 ± 1.4 8.5 ± 1.5 8.6 ± 1.4 8.2 ± 1.3 8.8 ± 1.8 0.067 Total dose of rFSH (IU) 1669.0 ± 531.3 1627.5 ± 570.9 1580.1 ± 596.0 1663.2 ± 376.8 1643.1 ± 725.0 0.111 Hormone profile on the initiation day of rFSH FSH base (IU/ml) 6.8 ± 1.7 6.7 ± 1.9 6.7 ± 2.3 6.1 ± 1.2 5.6 ± 2.0 0.001 LH base (IU/ml) 6.3 ± 2.7 6.4 ± 3.1 6.2 ± 3.2 5.0 ± 3.0 5.8 ± 3.5 0.103 E2 base (IU/ml) 35.9 ± 14.4 41.1 ± 19.2 42.6 ± 19.2 37.3 ± 13.8 36.3 ± 14.0 0.013 Duration of GnRH-ant (days) 5.4 ± 1.1 5.3 ± 1.2 5.1 ± 1.2 4.5 ± 1.1 5.2 ± 1.2 0.001 Total dose of GnRH-ant (mg) 1.3 ± 0.3 1.3 ± 0.3 1.3 ± 0.3 1.1 ± 0.3 1.4 ± 0.3 0.020 Hormone profile on the initiation day of GnRH-ant FSH (IU/ml) 12.1 ± 3.9 12.3 ± 4.1 12.2 ± 3.8 15.5 ± 5.0 13.2 ± 5.8 0.036 LH (IU/ml) 2.1 ± 1.1 3.9 ± 2.0 5.8 ± 3.2 6.9 ± 4.2 13.7 ± 12.1 ＜0.001 E2 (IU/ml) 568.4 ± 387.2 758.3 ± 490.2 838.2 ± 528.5 984.6 ± 484.5 1008.2 ± 433.0 ＜0.001 Hormone profile on the hCG day FSH (IU/ml) 13.4 ± 7.1 13.5 ± 10.4 12.0 ± 4.4 15.2 ± 5.5 12.1 ± 5.0 0.022 LH (IU/ml) 3.6 ± 4.7 3.9 ± 2.5 4.7 ± 3.4 4.1 ± 2.9 6.1 ± 7.9 0.001 E2 (IU/ml) 2717.0 ± 1421.7 3012.0 ± 1666.5 3260.8 ± 1767.2 3097.7 ± 1586.5 3792.7 ± 1652.5 0.002 P (Iu/ml) 0.9 ± 1.3 0.7 ± 0.4 0.8 ± 0.4 09 ± 0.4 0.8 ± 0.4 0.176 Endometrial thickness (mm) on the hCG day 10.9 ± 2.3 10.6 ± 2.4 10.5 ± 2.1 10.9 ± 2.1 10.9 ± 1.9 0.279 COH outcomes Number of oocytes retrieved 12.2 ± 6.0 12.7 ± 7.3 13.0 ± 7.5 13.6 ± 7.8 15.6 ± 9.3 0.355 Follicular output rate (%) 78.9 ± 39.7 79.9 ± 80.7 77.1 ± 38.7 84.8 ± 33.1 77.7 ± 36.1 0.321 Number of Mature oocytes 9.3 ± 5.1 10.0 ± 6.5 10.6 ± 6.6 10.0 ± 6.6 11.8 ± 7.9 0.461 Number of 2PN fertilized oocytes 7.9 ± 4.6 8.3 ± 5.6 9.0 ± 5.9 8.6 ± 5.8 9.7 ± 6.1 0.498 2PN Fertilized rate(%) 73.0 ± 24.1 69.3 ± 24.5 73.9 ± 20.9 74.6 ± 26.4 68.1 ± 22.2 0.225 Number of cleavages 7.9 ± 4.6 8.3 ± 5.6 8.9 ± 5.9 8.6 ± 5.8 9.7 ± 6.1 0.494 Cleavage rate(%) 97.7 ± 14.3 96.5 ± 18.0 99.8 ± 1.7 94.2 ± 22.9 100 ± 0 0.257 Number of high-quality embryos 4.3 ± 3.5 4.5 ± 4.2 4.7 ± 3.9 4.8 ± 4.6 4.9 ± 4.0 0.899 High-quality embryonic rate (%) 54.3 ± 33.0 52.7 ± 32.8 53.5 ± 31.2 52.2 ± 35.1 55.4 ± 32.3 0.981 No. of embryo available 5.2 ± 2.7 5.2 ± 2.7 5.7 ± 3.0 5.2 ± 3.0 5.7 ± 3.0 0.535 Embryo transfer and pregnancy outcomes No. of ET patients 179 71 39 5 8 Cancellation rate(%) 54.7 60.3 60.6 73.7 72.4 0.143 Implantation rate(%) 37.0 42.2 40.4 33.3 63.6 0.439 95%CI 0.310–0.429 0.324–0.519 0.272–0.535 -0.209-0.875 0.297–0.975 D3 embryos Implantation rate (%) 27.0 36.2 30.8 40.0 57.1 0.287 95%CI 0.203–0.337 0.246–0.479 0.156–0.459 -0.280-1.080 0.077–1.066 D5 embryos Implantation rate (%) 57.8 54.5 61.1 0 75.0 0.815 95%CI 0.470–0.687 0.366–0.725 0.362–0.861 - -0.046-1.546 Clinical pregnancy rate(%) 48.0 54.9 51.3 40.0 75.0 0.542 95%CI 0.407–0.554 0.431–0.668 0.349–0.677 -0.280-1.080 0.363–1.137 Early abortion rate (%) 10.5 15.4 10.0 0 0 0.850 There was a total of 721 first IVF/ICSI patient-cycles with 395 cycles (54.8%) in LH decreased more than 50% before the initiation of GnRH-ant (A1), 179 cycles (24.8%) in LH decreased 25%-50% (B1), 99 cycles (13.7%) in LH change less than 25%(C1), 19 cycles (2.6%) in LH increased 25%-50% (D1) and 29 cycles (4.0%) in LH increased more than 50%(E1).Table 1 shows the patients baseline characteristics, protocol related parameters and cycle outcomes, such as COH outcomes, Embryo transfer and pregnancy outcomes. There was significant difference regarding infertility years among groups A1, B1, C1, D1, E1(P＜0.05)with the longest in group E1. At the same time, no significant differences were detected in age, BMI, infertility factors, AMH level and antral follicle number (P > 0.05). The results showed that although duration of stimulation and the total dose of Gn in 5 groups had no statistical differences, the total dose of GnRH-ant and duration of antagonist in group D1 were lower than those in other groups (P < 0.05). There were significant differences in FSH and E2 levels among all groups during ovarian stimulation(P＜0.05). while there were no statistical differences in progesterone (P) level and endometrial thickness in 5 groups on HCG trigger day(P＞0.05). It was found that there was no significant correlation between LH change before the antagonist initiation and COH outcome items among all groups (P > 0.05). There were no statistically significant differences regarding the ET outcomes among all groups (P > 0.05). The effect of LH level changes after the initiation of GnRH-ant on the outcome of COH and ET (Table 2 ). Table 2 Comparisons of different changes in LH levels after initiation of GnRH-ant A2 B2 C2 D2 E2 P value No. of patients 100 110 178 62 271 Baseline characteristics Age(years) 30.3 ± 3.9 30.6 ± 4.6 31.0 ± 4.5 31.6 ± 5.1 32.2 ± 5.3 0.004 Body mass index (kg/m 2 ) 21.1 ± 3.0 20.9 ± 2.4 21.2 ± 2.4 21.6 ± 4.4 22.3 ± 2.9 ＜0.001 Duration of fertility (years) 3.6 ± 2.2 3.6 ± 2.4 3.7 ± 2.7 3.3 ± 2.5 3.4 ± 2.6 0.095 Etiology of infertility (ratio) Primary infertility 55/100 51/110 103/178 29/62 120/271 0.044 Secondary infertility 45/100 59/110 75/178 33/62 151/171 0.044 Female factor 76/100 87/110 126/178 45/62 195/271 0.592 Male factor 21/100 22/110 44/178 13/62 67/271 0.592 Combined 3/100 1/110 8/178 4/62 9/271 0.592 AMH 7.5 ± 4.1 6.4 ± 5.0 5.7 ± 4.1 4.8 ± 3.8 3.9 ± 3.4 ＜0.001 Antral follicular count 16.6 ± 5.4 15.0 ± 6.8 13.8 ± 6.3 11.9 ± 6.0 12.0 ± 5.9 ＜0.001 Ovarian stimulation parameters Duration of stimulation (days) 8.4 ± 1.4 8.6 ± 1.3 8.5 ± 1.4 8.3 ± .14 8.9 ± 1.5 0.004 Total dose of rFSH (IU) 1379.0 ± 445.1 1549.8 ± 540.4 1556.1 ± 439.3 1590.3 ± 558.7 1853.4 ± 596.1 ＜0.001 Hormone profile on the initiation day of rFSH FSH base (IU/ml) 6.1 ± 1.7 6.4 ± 1.7 7.0 ± 2.0 7.0 ± 1.7 6.8 ± 1.9 ＜0.001 LH base (IU/ml) 7.6 ± 3.8 6.8 ± 3.0 6.6 ± 2.8 6.0 ± 2.1 5.3 ± 2.4 ＜0.001 E2 base (IU/ml) 39.8 ± 18.2 40.0 ± 17.2 41.1 ± 17.9 35.5 ± 17.3 35.5 ± 14.0 0.002 Duration of GnRH-ant (days) 5.2 ± 1.1 5.2 ± 1.2 5.3 ± 1.2 5.2 ± 1.2 5.4 ± 1.2 0.457 Total dose of GnRH-ant (mg) 1.3 ± 0.3 1.3 ± 0.3 1.3 ± 0.3 1.3 ± 0.3 1.3 ± 0.3 0.570 Hormone profile on the initiation day of GnRH-ant FSH (IU/ml) 12.1 ± 3.4 12.6 ± 4.2 12.5 ± 4.1 12.3 ± 4.2 12.2 ± 4.2 0.885 LH (IU/ml) 7.9 ± 7.9 4.6 ± 2.8 3.2 ± 2.2 2.6 ± 1.4 2.2 ± 1.4 ＜0.001 E2 (IU/ml) 1090.8 ± 440.9 862.2 ± 428.7 713.8 ± 464.6 586.8 ± 394.4 457.0 ± 335.3 ＜0.001 Hormone profile on the hCG day FSH (IU/ml) 11.1 ± 3.7 12.6 ± 4.6 14.2 ± 13.3 13.5 ± 4.9 13.5 ± 4.4 ＜0.001 LH (IU/ml) 2.3 ± 1.7 2.8 ± 1.8 3.2 ± 2.1 3.6 ± 1.9 5.5 ± 6.1 ＜0.001 E2 (IU/ml) 4016.8 ± 1644.7 3283.1 ± 1478.1 2903.1 ± 1524.9 2438.3 ± 1350.6 2484.4 ± 1415.6 ＜0.001 P (IU/ml) 0.8 ± 0.5 0.9 ± 1.2 0.8 ± 0.4 0.6 ± 0.3 0.8 ± 1.3 0.049 Endometrial thickness (mm) on the hCG day 10.4 ± 2.3 10.8 ± 2.5 10.8 ± 2.0 10.0 ± 2.1 10.9 ± 2.3 0.486 COH outcomes Number of oocytes retrieved 16.4 ± 7.1 14.5 ± 7.1 11.9 ± 6.0 11.8 ± 7.5 11.0 ± 6.1 ＜0.001 Follicular output rate (%) 86.2 ± 40.5 83.7 ± 97.1 77.1 ± 36.2 81.2 ± 67.9 75.2 ± 31.5 0.208 Number of Mature oocytes 12.8 ± 6.9 11.7 ± 6.3 9.2 ± 5.3 9.1 ± 5.7 8.4 ± 5.0 ＜0.001 Number of 2PN fertilized oocytes 10.6 ± 5.8 10.1 ± 5.5 7.9 ± 4.8 7.7 ± 4.8 7.0 ± 4.6 ＜0.001 2PN Fertilized rate(%) 69.7 ± 23.0 75.2 ± 20.1 72.1 ± 23.2 72.8 ± 22.9 71.5 ± 25.9 0.631 Number of cleavages 10.6 ± 5.8 10.0 ± 5.5 7.9 ± 4.8 7.6 ± 4.8 7.0 ± 4.6 ＜0.001 Cleavage rate(%) 97.9 ± 14.1 97.9 ± 13.5 98.0 ± 13.0 96.7 ± 17.8 97.5 ± 15.0 0.924 Number of high-quality embryos 5.6 ± 3.8 5.8 ± 4.5 4.6 ± 3.4 4.3 ± 3.9 3.5 ± 3.4 ＜0.001 High-quality embryonic rate (%) 55.4 ± 18.9 55.2 ± 33.2 59.1 ± 33.0 54.0 ± 29.0 49.0 ± 33.8 0.047 Embryo transfer and pregnancy outcomes No. of ET patients 23 26 83 29 142 Cancellation rate(%) 77.0 76.4 53.4 53.2 47.6 ＜0.001 Implantation rate(%) 48.1 35.3 41.5 39.0 37.5 0.803 95%CI 0.280–0.683 0.184–0.522 0.326–0.503 0.234–0.546 0.309–0.441 D3 Implantation rate (%) 44.4 28.6 33.7 32.1 27.9 0.745 95%CI 0.039–0.850 0.075–0.496 0.237–0.437 0.137–0.506 0.206–0.350 D5 Implantation rate (%) 50.0 46.2 61.8 53.8 60.7 0.803 95%CI 0.244–0.756 0.148–0.775 0.446–0.790 0.225–0.852 0.480–0.733 Clinical pregnancy rate(%) 43.5 42.3 50.6 48.3 52.8 0.832 95%CI 0.216–0.654 0.220–0.627 0.396–0.616 0.289–0.676 0.445–0.611 Early abortion rate (%) 10.0 0 7.1 7.1 16 0.512 Table 2 shows a total of 721 first IVF/ICSI patient-cycles with 100 cycles (13.9%) in LH decreased more than 50% after the initiation of GnRH-ant (A2), 110 cycles (15.3%) in LH decreased 25%-50% (B2), 178 cycles (24.7%) in LH change less than 25%(C2), 62 cycles (8.6%) in LH increased 25%-50% (D2) and 271 cycles (37.6%) in LH increased more than 50%(E2). According to Kruskal-Wallis test, there were statistically significant differences in age, BMI, infertility type, AMH and AFC among all groups, with age and BMI higher in group E2 than those in other groups (P < 0.05) but AMH and AFC lower in group E2 (P < 0.001). The days of ovarian stimulation and the total amount of Gn in group A2 were lower than those in other groups (P = 0.004, P < 0.001). And FSH level in group A2 was the lowest on the initiation day of stimulation and trigger day(P < 0.001). Among the 5 groups, the number of oocytes retrieved, mature oocytes, 2PN fertilized oocytes, embryo cleavage and the numbers of embryo available in group A2 were significantly higher than those in other groups (P < 0.05). The group A2 had the highest cancellation rate (77.0%) (P 0.05). Discussion It has been demonstrated that < 1% of LH receptors being occupied is enough to elicit a normal steroidogenic response 11 . However, there is no consensus on the optimal clinical LH threshold range for COH in assisted reproductive technology (ART) 12 . In the study by Bosch E and coworkers 13 , no differences were observed between the number of oocytes recovered or the fertilization, implantation, and pregnancy rates of different LH concentrations on days 3, 6, and 8 of stimulation and on the day of hCG, what was also supported by other similar studies 14 . During the ovarian stimulation process of GnRH-ant protocol, 55%(395/721) of the patients showed a spontaneously significant decrease in LH level before the addition of the antagonist, and only a few patients(37/721) had a significant increase in LH level. The significant decrease in LH level before the addition of antagonists may be related to the production of gonadotrophin surge-attenuating factor (GnSAF). Previous studies 15 – 16 have found that in the process of assisted reproduction using exogenous gonadotropin to promote follicle development, exogenous gonadotropin was found to stimulate the ovarian production of an uncharacterized hormone known by its specific effect of reducing pituitary responsiveness to GnRH. This hormone has been called gonadotrophin surge-attenuating factor (GnSAF). It regulates LH secretion by reducing the sensitivity of the pituitary to GnRH and antagonizing the stimulatory effects of oestradiol on GnRH-induced LH secretion. The main role of GnSAF is probably the negative regulation of pulsatile LH secretion, mainly during the first half of the follicular phase. What’s more, the results of this study showed that the change of LH level before the addition of the antagonist did not affect the outcome of the COH and pregnancy outcome. It was basically consistent with the results of Vanetik S et al. 's study 3 , they proposed that there was no statistical difference in pregnancy outcome when LH level increased or decreased on the 5th day compared with that on the initiation day during COH. While the results of a retrospective study involving 2116 fresh ET cycles showed that before antagonist addition, the oocytes retrieved rate and fertilization rate in the group with LH increased were lower than those in the group with LH decreased 17 , but there was no statistical difference in pregnancy-related outcomes among the groups. The changes of LH level before and after the addition of antagonists had a significant difference in the outcome of ovarian stimulation with the number of eggs and available embryos in group A2 significantly higher than those in other groups. But, no significant difference was found between the change of LH level and embryo transfer result. It was revealed in our study the total rFSH dose was significantly lower in people with LH decreased ≥ 50% after the addition of antagonists during COH, while their E2 level was relatively higher on trigger day. We consider that it was associated with a better ovarian response in people with significantly decreased LH level after antagonist addition, for AMH was higher in them, and AMH has been proved with high predictive value for ovarian response 18 . It has been proved that with the increase of estrogen level (E2 ≤ 4 800 pg/mL) in the GnRH-ant protocol, both the number of oocytes retrieved and embryos obtained increased 19 . Similarly, we found people who with significantly decreased LH had a higher average level of E2, therefore had a relatively better COH outcomes. Besides, the number of oocytes retrieved, mature oocytes, 2PN fertilized oocytes, embryos cleavage and the numbers of embryo available were negatively correlated with LH level changes. In the study by Scheffer JB and coworkers 20 , they found that age was negatively correlated with the quality of D3 and D5 embryos, but AMH and AFC were positively correlated with the quality of D3 and D5 embryos. Here in this study we also found that the number of high-quality embryos and high-quality embryonic rate were lower in patients with significantly increased LH level, which was related to that patient with advanced age, low AMH and low AFC was more prone to appear LH significantly increase. There are many factors affecting the outcomes of COH and pregnancy. Such as E2, LH and P levels on trigger day as well as age and BMI all have certain influence on the outcomes of ovulation stimulation and pregnancy, while LH level on trigger day is negatively correlated with the number of oocytes retrieved, but has no significant correlation with the outcome of pregnancy 21 .The conclusion is consistent with Ji Hui and coworkers’ results 22 , they proposed that low LH levels on trigger day can predict higher oocytes retrieved number but no effect on early miscarriage rate or clinical pregnancy rate. Similarly, we observed that there were no significant differences in pregnancy outcomes among different LH change groups after GnRH-ant addition (P > 0.05). However, Younis JS and coworkers found that a decrease of LH level > 50% significantly reduced the embryo transfer outcome 23 . And in the study by Geng Y and coworkers 24 , the clinical pregnancy rates were reduced in high ovarian response patients with LH surge during ovulation stimulation in GnRH-ant protocol. Conclusion In conclusion, this study demonstrates that LH level changes before GnRH-ant initiation had no effect on COH and ET outcomes. The number of oocytes retrieved, mature oocytes, fertilized oocytes, embryos cleavage, high quality embryos, high-quality embryonic rate and the numbers of embryo available have significant differences with the change of LH after GnRH-ant initiation, but without influence on the pregnancy outcome. Therefore, the LH level changes in GnRH antagonist protocol can predict the outcomes of ovulation stimulation to a certain extent, but it cannot be used to predict the outcome of clinical pregnancy. What’s more, the limitation of this study lies in the fact that it is a retrospective study, which is influenced by unnoticed bias or confounding factors. Meanwhile, on account of the unequal sample size among the groups, the sample may not accurately reflect the overall situation. Hence, more comparative studies are needed in the future. Declarations Disclosure statement. No potential conflict of interest was reported by the authors. Ethical Approval The study was approved by the Ethics Committee Review Board of The Third Affiliated Hospital, Sun Yat-sen University (No: [2021]02-246-01). All procedures performed in this study were in accordance with the Ethical Review of Biomedical Research Involving People (2016) by the National Health and Family Planning Commission, the Good Clinical Practice Guideline of Pharmaceutical Products (2020), Provisions for Medical Device Classification (2004), Guidelines for Ethical Review of Drug Clinical Trials (2010), (2007) by the National Food and Medical Products Administration, Administrative Measures for Clinical Research on Stem Cells (Trial) (2015) by the National Health and Family Planning Commission and the National Food and Medical Products Administration, as well as Declaration of Helsinki by WMA, International Ethical Guidelines for Human Biomedical Research Involving Human Subjects by ICH-GCP and CIOMS. Consent for publication Not applicable. Authors’ contributions Liuhong Cai and Jingshuang Zhou proposed the conceptualization and methodology. Jianhong Chen and Feifei Tang conducted data collection and sorting. Jingshuang Zhou performed the data analysis and wrote the main manuscript. Jianping Ou and Xin Tao performed the validation. Liuhong Cai performed the supervision, reviewed and revised the original draft. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors. Funding This research received no external funding. Availability of data and materials The relevant data needed for the article is presented in the article content and in the attached file table. References Filicori M. The role of luteinizing hormone in folliculogenesis and ovulation induction. Fertil Steril. 1999;71(3):405-414. Pacchiarotti A, Selman H, Valeri C, et al. Ovarian Stimulation Protocol in IVF: An Up-to-Date Review of the Literature. Curr Pharm Biotechnol. 2016; 17(4):303-315. Vanetik S, Beck-Fruchter R, Segal L, et al. The Importance of Mid-Follicular Phase Luteinizing Hormone Rise in GnRH Antagonist-Based Ovarian Stimulation for IVF. Gynecol Obstet Invest. 2020;85(2):184-188. Luo Y, Liu S, Su H, et al. Low Serum LH Levels During Ovarian Stimulation With GnRH Antagonist Protocol Decrease the Live Birth Rate After Fresh Embryo Transfers but Have No Impact in Freeze-All Cycles. Front Endocrinol (Lausanne). 2021; 12: 640047. Zhang D, Zhang D, Sun Z, et al. The effect of a transient premature luteinizing hormone surge without elevated serum progesterone on in vitro fertilization outcomes in a gonadotropin-releasing hormone antagonist flexible protocol. Gynecol Endocrinol. 2020;36(6):550-553. Huirne JA, van Loenen AC, Schats R, et al. Dose-finding study of daily GnRH antagonist for the prevention of premature LH surges in IVF/ICSI patients: optimal changes in LH and progesterone for clinical pregnancy. Hum Reprod. 2005;20(2):359-367. Segal L, Fainaru O, Kol S. Anovulatory Patients Demonstrate a Sharp Decline in LH Levels upon GnRH Antagonist Administration during IVF Cycles. Rambam Maimonides Med J. 2017;8(2): e0021. Liu M, Liu S, Li L, et al. LH Levels May Be Used as an Indicator for the Time of Antagonist Administration in GnRH Antagonist Protocols-A Proof-Of-Concept Study. Front Endocrinol (Lausanne). 2019; 10: 67. Hosein Rashidi B, Kabodmehri R, Shariat M, et al. Luteinizing hormone changes in gonadotropin-releasing hormone antagonist protocol in in vitro fertilization cycles: A cross-sectional study. Int J Reprod Biomed. 2019;17(3):209–216. Kummer NE, Weitzman VN, Benadiva CA, et al. In vitro fertilization outcomes in patients experiencing a premature rise in luteinizing hormone during a gonadotropin-releasing hormone antagonist cycle. Fertil Steril. 2011; 95(8): 2592-2594. Hillier SG. Current concepts of the roles of follicle stimulating hormone and luteinizing hormone in folliculogenesis. Hum Reprod. 1994;9(2):188-191. Soave I, Marci R. Exogenous luteinizing hormone supplementation in controlled ovarian stimulation: why, when and to whom? Curr Med Res Opin. 2018;34(5):939-941. Bosch E, Escudero E, Crespo J, et al. Serum luteinizing hormone in patients undergoing ovarian stimulation with gonadotropin-releasing hormone antagonists and recombinant follicle-stimulating hormone and its relationship with cycle outcome. Fertil Steril. 2005;84(5):1529-1532. Doody KJ, Devroey P, Leader A, et al. No association between endogenous LH and pregnancy in a GnRH antagonist protocol: part I, corifollitropin alfa. Reprod Biomed Online. 2011;23(4):449-456. Fowler PA, Sorsa-Leslie T, Harris W, et al. Ovarian gonadotrophin surge-attenuating factor (GnSAF): where are we after 20 years of research? Reproduction. 2003, 126(6): 689-699. Messinis IE, Messini CI, Anifandis G, et al. Gonadotropin Surge-Attenuating Factor: A Nonsteroidal Ovarian Hormone Controlling GnRH-Induced LH Secretion in the Normal Menstrual Cycle. Vitam Horm. 2018, 107: 263-286. Huang Q, Nong Y, Zhang X, et al. Effects of increasing serum luteinizing hormone levels during early phase of the gonadotropin-releasing hormone antagonist protocol on clinical outcomes of the in vitro fertilization cycle. Gynecol Endocrinol. 2022;38(2):135-139. Zhang Y, Wang L, Zhao S, et al. Predictive value of anti-Müllerian hormone on pregnancy outcomes in in-vitro fertilization/intracytoplasmic single sperm injection patients at different ages. Arch Gynecol Obstet. 2021;304(6):1611-1620. Wang Wei, Cao Yi-juan, Ma Juan. Effect of estradiol level on pregnancy outcome on the hCG day of antagonist protocol. Journal of Bengbu Medical College. 2020; 45(11):1494-1497. Scheffer JB, Carvalho RF, Aguiar APS, et al. Which ovarian reserve marker relates to embryo quality on day 3 and blastocyst; age, AFC, AMH? JBRA Assist Reprod. 2021;25(1):109-114. Wang AC, Wang Y, Wu FX, et al. Assessing predictors for the success of GnRH antagonist protocol in reproductive women in IVF/ICSI - in fresh cycles. Biomed Rep. 2017;7(5):482-486. Ji Hui, Chen Meng-xi, Zhao Chun, et al. Effect of LH level on pregnancy outcome of IVF during controlled ovarian hyperstimulation with antagonist protocol. Journal of Reproductive Medicine. 2017; 26(10):972-977. Younis JS, Laufer N. Recombinant luteinizing hormone supplementation to recombinant follicle stimulating hormone therapy in gonadotropin releasing hormone analogue cycles: what is the evidence? Curr Med Res Opin. 2018;34(5):881-886. Geng Y, Lai Q, Xun Y, et al. The effect of premature luteinizing hormone increases among high ovarian responders undergoing a gonadotropin-releasing hormone antagonist ovarian stimulation protocol. Int J Gynaecol Obstet. 2018;142(1):97-103. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2529757","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":172036129,"identity":"35161347-93e8-4772-a403-665600b49705","order_by":0,"name":"Zhou Jing-shuang","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhou","middleName":"","lastName":"Jing-shuang","suffix":""},{"id":172036130,"identity":"9d620e9e-26f9-43a5-b37d-3149789de2a1","order_by":1,"name":"Chen Jian-hong","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chen","middleName":"","lastName":"Jian-hong","suffix":""},{"id":172036131,"identity":"43e9373f-f0d9-42ba-a3c0-455f4aa8312f","order_by":2,"name":"Tang Fei-fei","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tang","middleName":"","lastName":"Fei-fei","suffix":""},{"id":172036133,"identity":"c17e5878-3784-458b-b80a-709deec29fc3","order_by":3,"name":"Ou Jian-ping","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ou","middleName":"","lastName":"Jian-ping","suffix":""},{"id":172036135,"identity":"b39bbd38-6857-4c56-955c-7e99863ba3d5","order_by":4,"name":"Tao Xin","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tao","middleName":"","lastName":"Xin","suffix":""},{"id":172036137,"identity":"f68af89f-46e7-4c4a-92fe-86baa00b97c0","order_by":5,"name":"Cai Liu-hong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYFACxsbDDBUMDGzscJEEgloaDjOcAWphJl4LA8NhxjYgSbQW/vbDDYcL522T52NmYP7M8+cwAz97jgHDzx24tUicSWw4PHPbbcM2ZgY2ad62wwySPW8MGHvP4NZiwADUwrvtNiNICzMv0F8GN3IMmMFOxaWF/yFQy5zb9m0wh9kT1CIBsqXhdiJQC4M0DxvQFgkCWiRuAG3hOXY7uQ2oTHJuWzqPxJlnBQd78Wjh709/+Jin5rbt/Pbmwx/e/LGW429P3vjgJx4tSICxgYmHgYEHxDxAlAawph9EKx0Fo2AUjIKRBAC9NU4kvOeKMwAAAABJRU5ErkJggg==","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Cai","middleName":"","lastName":"Liu-hong","suffix":""}],"badges":[],"createdAt":"2023-01-30 12:59:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2529757/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2529757/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":32341484,"identity":"6b24cd3f-34b1-4f06-b74d-68838f96ef2c","added_by":"auto","created_at":"2023-02-01 17:01:29","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":809650,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic diagram of research route\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-2529757/v1/f0ca42a7b311d85bcaabfdb2.png"},{"id":32490302,"identity":"10843565-9250-4616-8a71-1dd7d21851bd","added_by":"auto","created_at":"2023-02-05 13:55:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":525427,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2529757/v1/cd368612-23a9-4f2a-965c-deb0e95ea964.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The effect of luteinizing hormone changes in GnRH antagonist protocol on the outcome of controlled ovarian hyperstimulation and embryo transfer","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLuteinizing hormone (LH) is a glycoprotein hormone secreted by the gonadotropin cells of the anterior pituitary gland, which plays an important role in hormone generation, ovulation promotion and luteinization\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Gonadotropin-releasing hormone antagonist (GnRH-ant) protocol has been widely used in assisted reproduction in recent years due to its advantages of non-flare up effect, rapidly and effectively inhibiting the LH surge, reduction of ovarian hyperstimulation syndrome (OHSS) incidence and short treatment period\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e。LH level changes diversitily during COH, most LH levels spontaneously decrease before the administration of antagonist, while about 1/3 LH levels increased, and there are differences in LH level changes between before and after the administration of antagonist\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eExcessive or insufficient LH levels as well as significant rise or decrease of LH levels will reduce the clinical pregnancy rate\u003csup\u003e\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. While the LH level decreased achieved better COH outcomes than increased ones\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Meanwhile, there was no difference in clinical outcomes with different LH levels or LH level changes in similar articles\u003csup\u003e\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eUp to date, there is no unified conclusion on the effect of LH level changes on COH and fresh ET outcomes in GnRH-ant protocol. Most of published studies have focused on the significant changes of LH level at a single time point, here we study the LH level changes before and after the initiation of antagonist during COH. The purpose of this study was to explore the effect of LH level changes on COH and ET outcomes.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cp\u003eA retrospective study was performed, analyzing data from 721 the first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles performed at Center for Reproductive Medicine, The Third Affiliated Hospital, Sun Yat-sen University (China, Guangdong) during the year 2019.\u003c/p\u003e \u003cp\u003eThe research steps are shown in the Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e The study was approved by the Ethics Committee Review Board of The Third Affiliated Hospital, Sun Yat-sen University (No: [2021]02-246-01).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInclusion Criteria\u003c/h2\u003e \u003cp\u003ePatients who underwent ovarian stimulation with GnRH-ant (ganirelix [Ganirest\u0026reg;, 0.25 mg; MSD] or cetrorelix [Cetrotide\u0026reg;, 0.25 mg; Merck]) protocol to suppress the pituitary and patient with age\u0026thinsp;\u0026ge;\u0026thinsp;20 years old and \u0026le;\u0026thinsp;45 years old were enrolled in this study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eExclusion Criteria\u003c/h2\u003e \u003cp\u003ePatients who underwent ovarian stimulation with non-GnRH antagonist protocol, patients with history of hydrosalpinx, uterine malformation and uterine adhesions, endometriosis, endometrial polyps and other diseases or a concurrent medical condition that have to cancel oocyte retrieval were excluded in this study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eProtocol\u003c/h2\u003e \u003cp\u003eGnRH-ant protocol was applied in this study. COH began on day 2 or 3 of a\u003c/p\u003e \u003cp\u003emenstrual period with initial injections of 150\u0026ndash;300IU of gonadotropin (Gn) (Gonal F, 450IU; Merck/ Follistim, 300IU; MSD). Antagonist ganirelix, (Ganirest, 0.25 mg; MSD) or cetrorelix (Cetrotide, 0.25 mg; Merck) was administered 4 days later according to fixed GnRH antagonist protocol. Recombinant human chorionic gonadotropin (rhCG) (Ovitrelle, 250 ug; Merck) or human chorionic gonadotropin (hCG, 10000IU; Lizhu Pharmaceuticals) was administered once when three leading follicles reached\u0026thinsp;\u0026ge;\u0026thinsp;17 mm mean diameter or one leading follicle reached\u0026thinsp;\u0026ge;\u0026thinsp;18 mm mean diameter were observed, oocyte retrieval was performed 34\u0026ndash;36 h later. Blood samples were taken to measure hormone levels (FSH, LH, E2, P) on day 1 of ovarian stimulation (day 2\u0026ndash;3 of menstrual cycle), day 1 of the antagonist injection (day 6\u0026ndash;7 of menstrual cycle) and trigger day, meanwhile B-ultrasounds were performed for follicular size and number. After oocyte retrieval, IVF or ICSI was routinely performed and embryo culture was performed after fertilization.\u003c/p\u003e \u003cp\u003eCOH process were divided into 2 stages, before (stage 1) and after (stage 2) the GnRH-ant initiation, and each with 5 groups basing on LH levels: LH decreased more than 50% (A1, A2), decreased 25%-50% (B1, B2), change less than 25% (C1, C2), increased 25%-50% (D1, D2), and increased more than 50% (E1, E2).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eContinuous variables were presented as means\u0026thinsp;\u0026plusmn;\u0026thinsp;SD, categorical variables were presented as percentage. For quantitative data, Kruskal - Wallis tests were used for statistical analysis, while for qualitative data, Fisher's Exact test or Chi-Square test was used for statistical analysis. The significance of all statistical results was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, and statistical analysis was performed using SPSS software (SPSS Version 25.0.0.0, IBM Corp., USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eThe effect of LH level changes before the initiation of GnRH-ant on the outcome of COH and ET\u003c/span\u003e (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\n\u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eLH level changes before administration of GnRH-ant\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eA1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eB1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eC1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eD1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eE1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo. of patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eBaseline characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody mass index (kg/m 2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of fertility (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEtiology of infertility (ratio)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary infertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e190/395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e92/179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51/99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14/29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.866\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary infertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e205/395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87/179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48/99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15/29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.866\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale factor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e273/395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e141/179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77/99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23/29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale factor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e106/395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36/179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18/99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5/29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCombined\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16/395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2/179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4/99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1/29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAMH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAntral follicular count\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.3\u0026thinsp;\u0026plusmn;\u0026thinsp;7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eOvarian stimulation parameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of stimulation (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal dose of rFSH (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1669.0\u0026thinsp;\u0026plusmn;\u0026thinsp;531.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1627.5\u0026thinsp;\u0026plusmn;\u0026thinsp;570.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1580.1\u0026thinsp;\u0026plusmn;\u0026thinsp;596.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1663.2\u0026thinsp;\u0026plusmn;\u0026thinsp;376.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1643.1\u0026thinsp;\u0026plusmn;\u0026thinsp;725.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eHormone profile on the initiation day of rFSH\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFSH base (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLH base (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eE2 base (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.9\u0026thinsp;\u0026plusmn;\u0026thinsp;14.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.1\u0026thinsp;\u0026plusmn;\u0026thinsp;19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.6\u0026thinsp;\u0026plusmn;\u0026thinsp;19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.3\u0026thinsp;\u0026plusmn;\u0026thinsp;13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.3\u0026thinsp;\u0026plusmn;\u0026thinsp;14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of GnRH-ant (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal dose of GnRH-ant (mg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eHormone profile on the initiation day of GnRH-ant\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFSH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.7\u0026thinsp;\u0026plusmn;\u0026thinsp;12.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eE2 (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e568.4\u0026thinsp;\u0026plusmn;\u0026thinsp;387.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e758.3\u0026thinsp;\u0026plusmn;\u0026thinsp;490.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e838.2\u0026thinsp;\u0026plusmn;\u0026thinsp;528.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e984.6\u0026thinsp;\u0026plusmn;\u0026thinsp;484.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1008.2\u0026thinsp;\u0026plusmn;\u0026thinsp;433.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eHormone profile on the hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFSH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.4\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.5\u0026thinsp;\u0026plusmn;\u0026thinsp;10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eE2 (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2717.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1421.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3012.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1666.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3260.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1767.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3097.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1586.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3792.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1652.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP (Iu/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.176\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEndometrial thickness (mm) on the hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOH outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of oocytes retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.7\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.0\u0026thinsp;\u0026plusmn;\u0026thinsp;7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.6\u0026thinsp;\u0026plusmn;\u0026thinsp;7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.6\u0026thinsp;\u0026plusmn;\u0026thinsp;9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.355\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollicular output rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.9\u0026thinsp;\u0026plusmn;\u0026thinsp;39.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.9\u0026thinsp;\u0026plusmn;\u0026thinsp;80.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.1\u0026thinsp;\u0026plusmn;\u0026thinsp;38.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84.8\u0026thinsp;\u0026plusmn;\u0026thinsp;33.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.7\u0026thinsp;\u0026plusmn;\u0026thinsp;36.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of Mature oocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u0026thinsp;\u0026plusmn;\u0026thinsp;6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.461\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of 2PN fertilized oocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.498\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2PN Fertilized rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.0\u0026thinsp;\u0026plusmn;\u0026thinsp;24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69.3\u0026thinsp;\u0026plusmn;\u0026thinsp;24.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.9\u0026thinsp;\u0026plusmn;\u0026thinsp;20.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74.6\u0026thinsp;\u0026plusmn;\u0026thinsp;26.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.1\u0026thinsp;\u0026plusmn;\u0026thinsp;22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of cleavages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.9\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.494\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCleavage rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.7\u0026thinsp;\u0026plusmn;\u0026thinsp;14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.5\u0026thinsp;\u0026plusmn;\u0026thinsp;18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e99.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.2\u0026thinsp;\u0026plusmn;\u0026thinsp;22.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u0026thinsp;\u0026plusmn;\u0026thinsp;0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of high-quality embryos\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.899\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh-quality embryonic rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.3\u0026thinsp;\u0026plusmn;\u0026thinsp;33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.7\u0026thinsp;\u0026plusmn;\u0026thinsp;32.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.5\u0026thinsp;\u0026plusmn;\u0026thinsp;31.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.2\u0026thinsp;\u0026plusmn;\u0026thinsp;35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.4\u0026thinsp;\u0026plusmn;\u0026thinsp;32.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.981\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo. of embryo available\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmbryo transfer and pregnancy outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo. of ET patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCancellation rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImplantation rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.439\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.310\u0026ndash;0.429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.324\u0026ndash;0.519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.272\u0026ndash;0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.209-0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.297\u0026ndash;0.975\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eD3 embryos Implantation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.203\u0026ndash;0.337\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.246\u0026ndash;0.479\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.156\u0026ndash;0.459\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.280-1.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.077\u0026ndash;1.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eD5 embryos Implantation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.815\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.470\u0026ndash;0.687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.366\u0026ndash;0.725\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.362\u0026ndash;0.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.046-1.546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical pregnancy rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.542\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.407\u0026ndash;0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.431\u0026ndash;0.668\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.349\u0026ndash;0.677\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.280-1.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.363\u0026ndash;1.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEarly abortion rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eThere was a total of 721 first IVF/ICSI patient-cycles with 395 cycles (54.8%) in LH decreased more than 50% before the initiation of GnRH-ant (A1), 179 cycles (24.8%) in LH decreased 25%-50% (B1), 99 cycles (13.7%) in LH change less than 25%(C1), 19 cycles (2.6%) in LH increased 25%-50% (D1) and 29 cycles (4.0%) in LH increased more than 50%(E1).Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows the patients baseline characteristics, protocol related parameters and cycle outcomes, such as COH outcomes, Embryo transfer and pregnancy outcomes. There was significant difference regarding infertility years among groups A1, B1, C1, D1, E1(P＜0.05)with the longest in group E1. At the same time, no significant differences were detected in age, BMI, infertility factors, AMH level and antral follicle number (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\n\u003cp\u003eThe results showed that although duration of stimulation and the total dose of Gn in 5 groups had no statistical differences, the total dose of GnRH-ant and duration of antagonist in group D1 were lower than those in other groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There were significant differences in FSH and E2 levels among all groups during ovarian stimulation(P＜0.05). while there were no statistical differences in progesterone (P) level and endometrial thickness in 5 groups on HCG trigger day(P＞0.05).\u003c/p\u003e\n\u003cp\u003eIt was found that there was no significant correlation between LH change before the antagonist initiation and COH outcome items among all groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\n\u003cp\u003eThere were no statistically significant differences regarding the ET outcomes among all groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eThe effect of LH level changes after the initiation of GnRH-ant on the outcome of COH and ET\u003c/span\u003e (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"1\" id=\"Tab2\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparisons of different changes in LH levels after initiation of GnRH-ant\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eA2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eB2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eC2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eD2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eE2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo. of patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eBaseline characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBody mass index (kg/m \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of fertility (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEtiology of infertility (ratio)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary infertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51/110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e103/178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29/62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e120/271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary infertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59/110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75/178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33/62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e151/171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale factor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87/110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126/178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45/62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e195/271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale factor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22/110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44/178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13/62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67/271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCombined\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1/110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8/178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4/62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9/271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAMH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAntral follicular count\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.0\u0026thinsp;\u0026plusmn;\u0026thinsp;6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.8\u0026thinsp;\u0026plusmn;\u0026thinsp;6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.9\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eOvarian stimulation parameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of stimulation (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.3\u0026thinsp;\u0026plusmn;\u0026thinsp;.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal dose of rFSH (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1379.0\u0026thinsp;\u0026plusmn;\u0026thinsp;445.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1549.8\u0026thinsp;\u0026plusmn;\u0026thinsp;540.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1556.1\u0026thinsp;\u0026plusmn;\u0026thinsp;439.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1590.3\u0026thinsp;\u0026plusmn;\u0026thinsp;558.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1853.4\u0026thinsp;\u0026plusmn;\u0026thinsp;596.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eHormone profile on the initiation day of rFSH\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFSH base (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLH base (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eE2 base (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.8\u0026thinsp;\u0026plusmn;\u0026thinsp;18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.0\u0026thinsp;\u0026plusmn;\u0026thinsp;17.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.1\u0026thinsp;\u0026plusmn;\u0026thinsp;17.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.5\u0026thinsp;\u0026plusmn;\u0026thinsp;17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.5\u0026thinsp;\u0026plusmn;\u0026thinsp;14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of GnRH-ant (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.457\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal dose of GnRH-ant (mg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.570\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eHormone profile on the initiation day of GnRH-ant\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFSH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.885\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eE2 (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1090.8\u0026thinsp;\u0026plusmn;\u0026thinsp;440.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e862.2\u0026thinsp;\u0026plusmn;\u0026thinsp;428.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e713.8\u0026thinsp;\u0026plusmn;\u0026thinsp;464.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e586.8\u0026thinsp;\u0026plusmn;\u0026thinsp;394.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e457.0\u0026thinsp;\u0026plusmn;\u0026thinsp;335.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eHormone profile on the hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFSH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.2\u0026thinsp;\u0026plusmn;\u0026thinsp;13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLH (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.5\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eE2 (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4016.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1644.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3283.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1478.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2903.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1524.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2438.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1350.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2484.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1415.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEndometrial thickness (mm) on the hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOH outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of oocytes retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.4\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.5\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.9\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.0\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFollicular output rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86.2\u0026thinsp;\u0026plusmn;\u0026thinsp;40.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.7\u0026thinsp;\u0026plusmn;\u0026thinsp;97.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.1\u0026thinsp;\u0026plusmn;\u0026thinsp;36.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.2\u0026thinsp;\u0026plusmn;\u0026thinsp;67.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.2\u0026thinsp;\u0026plusmn;\u0026thinsp;31.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.208\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of Mature oocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.8\u0026thinsp;\u0026plusmn;\u0026thinsp;6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of 2PN fertilized oocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2PN Fertilized rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69.7\u0026thinsp;\u0026plusmn;\u0026thinsp;23.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.2\u0026thinsp;\u0026plusmn;\u0026thinsp;20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.1\u0026thinsp;\u0026plusmn;\u0026thinsp;23.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.8\u0026thinsp;\u0026plusmn;\u0026thinsp;22.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.5\u0026thinsp;\u0026plusmn;\u0026thinsp;25.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of cleavages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCleavage rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.9\u0026thinsp;\u0026plusmn;\u0026thinsp;14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.9\u0026thinsp;\u0026plusmn;\u0026thinsp;13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98.0\u0026thinsp;\u0026plusmn;\u0026thinsp;13.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.7\u0026thinsp;\u0026plusmn;\u0026thinsp;17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.5\u0026thinsp;\u0026plusmn;\u0026thinsp;15.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.924\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of high-quality embryos\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh-quality embryonic rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.4\u0026thinsp;\u0026plusmn;\u0026thinsp;18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.2\u0026thinsp;\u0026plusmn;\u0026thinsp;33.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.1\u0026thinsp;\u0026plusmn;\u0026thinsp;33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.0\u0026thinsp;\u0026plusmn;\u0026thinsp;29.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.0\u0026thinsp;\u0026plusmn;\u0026thinsp;33.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmbryo transfer and pregnancy outcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo. of ET patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCancellation rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImplantation rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.803\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.280\u0026ndash;0.683\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.184\u0026ndash;0.522\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.326\u0026ndash;0.503\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.234\u0026ndash;0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.309\u0026ndash;0.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eD3 Implantation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.745\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.039\u0026ndash;0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.075\u0026ndash;0.496\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.237\u0026ndash;0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.137\u0026ndash;0.506\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.206\u0026ndash;0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eD5 Implantation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.803\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.244\u0026ndash;0.756\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.148\u0026ndash;0.775\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.446\u0026ndash;0.790\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.225\u0026ndash;0.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.480\u0026ndash;0.733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical pregnancy rate(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.832\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.216\u0026ndash;0.654\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.220\u0026ndash;0.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.396\u0026ndash;0.616\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.289\u0026ndash;0.676\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.445\u0026ndash;0.611\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEarly abortion rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.512\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e shows a total of 721 first IVF/ICSI patient-cycles with 100 cycles (13.9%) in LH decreased more than 50% after the initiation of GnRH-ant (A2), 110 cycles (15.3%) in LH decreased 25%-50% (B2), 178 cycles (24.7%) in LH change less than 25%(C2), 62 cycles (8.6%) in LH increased 25%-50% (D2) and 271 cycles (37.6%) in LH increased more than 50%(E2). According to Kruskal-Wallis test, there were statistically significant differences in age, BMI, infertility type, AMH and AFC among all groups, with age and BMI higher in group E2 than those in other groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) but AMH and AFC lower in group E2 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\n\u003cp\u003eThe days of ovarian stimulation and the total amount of Gn in group A2 were lower than those in other groups (P\u0026thinsp;=\u0026thinsp;0.004, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). And FSH level in group A2 was the lowest on the initiation day of stimulation and trigger day(P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\n\u003cp\u003eAmong the 5 groups, the number of oocytes retrieved, mature oocytes, 2PN fertilized oocytes, embryo cleavage and the numbers of embryo available in group A2 were significantly higher than those in other groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The group A2 had the highest cancellation rate (77.0%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while there were no significant differences in ET outcomes among all groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIt has been demonstrated that \u0026lt; 1% of LH receptors being occupied is enough to elicit a normal steroidogenic response\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. However, there is no consensus on the optimal clinical LH threshold range for COH in assisted reproductive technology (ART)\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. In the study by Bosch E and coworkers\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e, no differences were observed between the number of oocytes recovered or the fertilization, implantation, and pregnancy rates of different LH concentrations on days 3, 6, and 8 of stimulation and on the day of hCG, what was also supported by other similar studies\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eDuring the ovarian stimulation process of GnRH-ant protocol, 55%(395/721) of the patients showed a spontaneously significant decrease in LH level before the addition of the antagonist, and only a few patients(37/721) had a significant increase in LH level. The significant decrease in LH level before the addition of antagonists may be related to the production of gonadotrophin surge-attenuating factor (GnSAF). Previous studies\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e–\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e have found that in the process of assisted reproduction using exogenous gonadotropin to promote follicle development, exogenous gonadotropin was found to stimulate the ovarian production of an uncharacterized hormone known by its specific effect of reducing pituitary responsiveness to GnRH. This hormone has been called gonadotrophin surge-attenuating factor (GnSAF). It regulates LH secretion by reducing the sensitivity of the pituitary to GnRH and antagonizing the stimulatory effects of oestradiol on GnRH-induced LH secretion. The main role of GnSAF is probably the negative regulation of pulsatile LH secretion, mainly during the first half of the follicular phase. What’s more, the results of this study showed that the change of LH level before the addition of the antagonist did not affect the outcome of the COH and pregnancy outcome. It was basically consistent with the results of Vanetik S et al. 's study\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e, they proposed that there was no statistical difference in pregnancy outcome when LH level increased or decreased on the 5th day compared with that on the initiation day during COH. While the results of a retrospective study involving 2116 fresh ET cycles showed that before antagonist addition, the oocytes retrieved rate and fertilization rate in the group with LH increased were lower than those in the group with LH decreased\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e, but there was no statistical difference in pregnancy-related outcomes among the groups.\u003c/p\u003e\u003cp\u003eThe changes of LH level before and after the addition of antagonists had a significant difference in the outcome of ovarian stimulation with the number of eggs and available embryos in group A2 significantly higher than those in other groups. But, no significant difference was found between the change of LH level and embryo transfer result. It was revealed in our study the total rFSH dose was significantly lower in people with LH decreased ≥ 50% after the addition of antagonists during COH, while their E2 level was relatively higher on trigger day. We consider that it was associated with a better ovarian response in people with significantly decreased LH level after antagonist addition, for AMH was higher in them, and AMH has been proved with high predictive value for ovarian response\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. It has been proved that with the increase of estrogen level (E2 ≤ 4 800 pg/mL) in the GnRH-ant protocol, both the number of oocytes retrieved and embryos obtained increased\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Similarly, we found people who with significantly decreased LH had a higher average level of E2, therefore had a relatively better COH outcomes. Besides, the number of oocytes retrieved, mature oocytes, 2PN fertilized oocytes, embryos cleavage and the numbers of embryo available were negatively correlated with LH level changes. In the study by Scheffer JB and coworkers\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e, they found that age was negatively correlated with the quality of D3 and D5 embryos, but AMH and AFC were positively correlated with the quality of D3 and D5 embryos. Here in this study we also found that the number of high-quality embryos and high-quality embryonic rate were lower in patients with significantly increased LH level, which was related to that patient with advanced age, low AMH and low AFC was more prone to appear LH significantly increase.\u003c/p\u003e\u003cp\u003eThere are many factors affecting the outcomes of COH and pregnancy. Such as E2, LH and P levels on trigger day as well as age and BMI all have certain influence on the outcomes of ovulation stimulation and pregnancy, while LH level on trigger day is negatively correlated with the number of oocytes retrieved, but has no significant correlation with the outcome of pregnancy\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e.The conclusion is consistent with Ji Hui and coworkers’ results\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e, they proposed that low LH levels on trigger day can predict higher oocytes retrieved number but no effect on early miscarriage rate or clinical pregnancy rate. Similarly, we observed that there were no significant differences in pregnancy outcomes among different LH change groups after GnRH-ant addition (P \u0026gt; 0.05). However, Younis JS and coworkers found that a decrease of LH level \u0026gt; 50% significantly reduced the embryo transfer outcome\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. And in the study by Geng Y and coworkers\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e, the clinical pregnancy rates were reduced in high ovarian response patients with LH surge during ovulation stimulation in GnRH-ant protocol.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study demonstrates that LH level changes before GnRH-ant initiation had no effect on COH and ET outcomes. The number of oocytes retrieved, mature oocytes, fertilized oocytes, embryos cleavage, high quality embryos, high-quality embryonic rate and the numbers of embryo available have significant differences with the change of LH after GnRH-ant initiation, but without influence on the pregnancy outcome. Therefore, the LH level changes in GnRH antagonist protocol can predict the outcomes of ovulation stimulation to a certain extent, but it cannot be used to predict the outcome of clinical pregnancy. What\u0026rsquo;s more, the limitation of this study lies in the fact that it is a retrospective study, which is influenced by unnoticed bias or confounding factors. Meanwhile, on account of the unequal sample size among the groups, the sample may not accurately reflect the overall situation. Hence, more comparative studies are needed in the future.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eDisclosure statement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNo potential conflict of interest was reported by the authors.\u003c/p\u003e\n\u003cp\u003eEthical Approval\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committee Review Board of The Third Affiliated Hospital, Sun Yat-sen University (No: [2021]02-246-01).\u0026nbsp;All procedures performed in this study were in accordance with\u0026nbsp;the Ethical Review of Biomedical Research Involving People (2016) by the National Health and Family Planning Commission, the Good Clinical Practice Guideline of Pharmaceutical Products (2020), Provisions for Medical Device Classification (2004), Guidelines for Ethical Review of Drug Clinical Trials (2010), (2007) by the National Food and Medical Products Administration, Administrative Measures for Clinical Research on Stem Cells (Trial) (2015) by the National Health and Family Planning Commission and the National Food and Medical Products Administration, as well as Declaration of Helsinki by WMA, International Ethical Guidelines for Human Biomedical Research\u0026nbsp;Involving Human Subjects by ICH-GCP and CIOMS.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u003c/p\u003e\n\u003cp\u003eLiuhong Cai and Jingshuang Zhou proposed the conceptualization and methodology.\u0026nbsp;Jianhong Chen and Feifei Tang conducted data collection and sorting. Jingshuang Zhou performed the data analysis and wrote the main manuscript.\u0026nbsp;Jianping Ou and Xin Tao performed the validation.\u0026nbsp;Liuhong Cai performed the supervision, reviewed and revised the original draft.\u0026nbsp;All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis research received no external funding.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe relevant data needed for the article is presented in the article content and in the attached file table.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFilicori M. The role of luteinizing hormone in folliculogenesis and ovulation induction. Fertil Steril. 1999;71(3):405-414. \u003c/li\u003e\n\u003cli\u003ePacchiarotti A, Selman H, Valeri C, et al. Ovarian Stimulation Protocol in IVF: An Up-to-Date Review of the Literature. Curr Pharm Biotechnol. 2016; 17(4):303-315.\u003c/li\u003e\n\u003cli\u003eVanetik S, Beck-Fruchter R, Segal L, et al. The Importance of Mid-Follicular Phase Luteinizing Hormone Rise in GnRH Antagonist-Based Ovarian Stimulation for IVF. Gynecol Obstet Invest. 2020;85(2):184-188.\u003c/li\u003e\n\u003cli\u003eLuo Y, Liu S, Su H, et al. Low Serum LH Levels During Ovarian Stimulation With GnRH Antagonist Protocol Decrease the Live Birth Rate After Fresh Embryo Transfers but Have No Impact in Freeze-All Cycles. Front Endocrinol (Lausanne). 2021; 12: 640047.\u003c/li\u003e\n\u003cli\u003eZhang D, Zhang D, Sun Z, et al. The effect of a transient premature luteinizing hormone surge without elevated serum progesterone on in vitro fertilization outcomes in a gonadotropin-releasing hormone antagonist flexible protocol. Gynecol Endocrinol. 2020;36(6):550-553.\u003c/li\u003e\n\u003cli\u003eHuirne JA, van Loenen AC, Schats R, et al. Dose-finding study of daily GnRH antagonist for the prevention of premature LH surges in IVF/ICSI patients: optimal changes in LH and progesterone for clinical pregnancy. Hum Reprod. 2005;20(2):359-367.\u003c/li\u003e\n\u003cli\u003eSegal L, Fainaru O, Kol S. Anovulatory Patients Demonstrate a Sharp Decline in LH Levels upon GnRH Antagonist Administration during IVF Cycles. Rambam Maimonides Med J. 2017;8(2): e0021.\u003c/li\u003e\n\u003cli\u003eLiu M, Liu S, Li L, et al. LH Levels May Be Used as an Indicator for the Time of Antagonist Administration in GnRH Antagonist Protocols-A Proof-Of-Concept Study. Front Endocrinol (Lausanne). 2019; 10: 67. \u003c/li\u003e\n\u003cli\u003eHosein Rashidi B, Kabodmehri R, Shariat M, et al. Luteinizing hormone changes in gonadotropin-releasing hormone antagonist protocol in in vitro fertilization cycles: A cross-sectional study. Int J Reprod Biomed. 2019;17(3):209\u0026ndash;216. \u003c/li\u003e\n\u003cli\u003eKummer NE, Weitzman VN, Benadiva CA, et al. In vitro fertilization outcomes in patients experiencing a premature rise in luteinizing hormone during a gonadotropin-releasing hormone antagonist cycle. Fertil Steril. 2011; 95(8): 2592-2594.\u003c/li\u003e\n\u003cli\u003eHillier SG. Current concepts of the roles of follicle stimulating hormone and luteinizing hormone in folliculogenesis. Hum Reprod. 1994;9(2):188-191.\u003c/li\u003e\n\u003cli\u003eSoave I, Marci R. Exogenous luteinizing hormone supplementation in controlled ovarian stimulation: why, when and to whom? Curr Med Res Opin. 2018;34(5):939-941.\u003c/li\u003e\n\u003cli\u003eBosch E, Escudero E, Crespo J, et al. Serum luteinizing hormone in patients undergoing ovarian stimulation with gonadotropin-releasing hormone antagonists and recombinant follicle-stimulating hormone and its relationship with cycle outcome. Fertil Steril. 2005;84(5):1529-1532. \u003c/li\u003e\n\u003cli\u003eDoody KJ, Devroey P, Leader A, et al. No association between endogenous LH and pregnancy in a GnRH antagonist protocol: part I, corifollitropin alfa. Reprod Biomed Online. 2011;23(4):449-456.\u003c/li\u003e\n\u003cli\u003eFowler PA, Sorsa-Leslie T, Harris W, et al. Ovarian gonadotrophin surge-attenuating factor (GnSAF): where are we after 20 years of research? Reproduction. 2003, 126(6): 689-699. \u003c/li\u003e\n\u003cli\u003eMessinis IE, Messini CI, Anifandis G, et al. Gonadotropin Surge-Attenuating Factor: A Nonsteroidal Ovarian Hormone Controlling GnRH-Induced LH Secretion in the Normal Menstrual Cycle. Vitam Horm. 2018, 107: 263-286. \u003c/li\u003e\n\u003cli\u003eHuang Q, Nong Y, Zhang X, et al. Effects of increasing serum luteinizing hormone levels during early phase of the gonadotropin-releasing hormone antagonist protocol on clinical outcomes of the in vitro fertilization cycle. Gynecol Endocrinol. 2022;38(2):135-139.\u003c/li\u003e\n\u003cli\u003eZhang Y, Wang L, Zhao S, et al. Predictive value of anti-M\u0026uuml;llerian hormone on pregnancy outcomes in in-vitro fertilization/intracytoplasmic single sperm injection patients at different ages. Arch Gynecol Obstet. 2021;304(6):1611-1620.\u003c/li\u003e\n\u003cli\u003eWang Wei, Cao Yi-juan, Ma Juan. Effect of estradiol level on pregnancy outcome on the hCG day of antagonist protocol. Journal of Bengbu Medical College. 2020; 45(11):1494-1497.\u003c/li\u003e\n\u003cli\u003eScheffer JB, Carvalho RF, Aguiar APS, et al. Which ovarian reserve marker relates to embryo quality on day 3 and blastocyst; age, AFC, AMH? JBRA Assist Reprod. 2021;25(1):109-114.\u003c/li\u003e\n\u003cli\u003eWang AC, Wang Y, Wu FX, et al. Assessing predictors for the success of GnRH antagonist protocol in reproductive women in IVF/ICSI - in fresh cycles. Biomed Rep. 2017;7(5):482-486.\u003c/li\u003e\n\u003cli\u003eJi Hui, Chen Meng-xi, Zhao Chun, et al. Effect of LH level on pregnancy outcome of IVF during controlled ovarian hyperstimulation with antagonist protocol. Journal of Reproductive Medicine. 2017; 26(10):972-977.\u003c/li\u003e\n\u003cli\u003eYounis JS, Laufer N. Recombinant luteinizing hormone supplementation to recombinant follicle stimulating hormone therapy in gonadotropin releasing hormone analogue cycles: what is the evidence? Curr Med Res Opin. 2018;34(5):881-886.\u003c/li\u003e\n\u003cli\u003eGeng Y, Lai Q, Xun Y, et al. The effect of premature luteinizing hormone increases among high ovarian responders undergoing a gonadotropin-releasing hormone antagonist ovarian stimulation protocol. Int J Gynaecol Obstet. 2018;142(1):97-103.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"gonadotropin-releasing hormone antagonist protocol, controlled ovarian hyperstimulation, fresh embryo transfer, LH level","lastPublishedDoi":"10.21203/rs.3.rs-2529757/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2529757/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo investigate the effect of LH level changes on the outcomes of controlled ovarian hyperstimulation (COH) and embryo transfer (ET) in gonadotropin-releasing hormone antagonist (GnRH-ant) protocol. Methods: A total of 721 patients undergoing GnRH-ant protocol COH for the first IVF/ICSI cycles were retrospectively analyzed. COH process were divided into 2 stages, before (stage 1) and after (stage 2) the GnRH-ant initiation, and each with 5 groups basing on LH levels: LH decreased more than 50% (A1, A2), decreased 25%-50% (B1, B2), change less than 25% (C1, C2), increased 25%-50% (D1, D2), and increased more than 50% (E1, E2). Results: There were no significant differences among groups of stage1 regarding COH and ET outcomes. For stage 2, the more obvious the decrease of LH level, the more the number of oocytes retrieved, mature oocytes, fertilized oocytes, embryos cleavaged and the numbers of embryo available (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), but without significant differences regarding ET outcomes. We also found the freeze-all rate in Group A2 was higher (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Conclusion: LH level changes before GnRH-ant addition were not related to COH and ET outcomes. LH level changes after the addition of GnRH-ant were related to the outcome of COH, and no significant differences were found relating to ET outcomes.\u003c/p\u003e","manuscriptTitle":"The effect of luteinizing hormone changes in GnRH antagonist protocol on the outcome of controlled ovarian hyperstimulation and embryo transfer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-02-01 17:01:24","doi":"10.21203/rs.3.rs-2529757/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"42cc8eab-af2c-4821-ba3f-8c12252a04b9","owner":[],"postedDate":"February 1st, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-03-01T10:59:22+00:00","versionOfRecord":[],"versionCreatedAt":"2023-02-01 17:01:24","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2529757","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2529757","identity":"rs-2529757","version":["v1"]},"buildId":"GqpaHPwrfC8PjnIFayRh5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}