Delayed hCG Trigger Does Not Improve Oocyte Maturation Rate: Evidence from 9,319 IVF/ICSI Cycles Using Three Controlled Ovarian Hyperstimulation Protocols

Delayed hCG Trigger Does Not Improve Oocyte Maturation Rate: Evidence from 9,319 IVF/ICSI Cycles Using Three Controlled Ovarian Hyperstimulation Protocols | 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 Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Delayed hCG Trigger Does Not Improve Oocyte Maturation Rate: Evidence from 9,319 IVF/ICSI Cycles Using Three Controlled Ovarian Hyperstimulation Protocols Seereipanha Ly, Jian Bai, Houming Su, Liu Jiang, Yan Li, Chenyuan Liu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9398415/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract OBJECTIVE To clarify whether dominant follicular proportion (DFP) on hCG trigger day is associated with oocyte maturation rate and low oocyte maturation rate across three widely used controlled ovarian hyperstimulation (COH) protocols in China, and to provide evidence for individualized trigger timing. STUDY DESIGN: A single-center, large-sample retrospective cohort study including 9,319 women undergoing their first fresh IVF or ICSI cycle between January 2021 and January 2024. Eligible participants were aged ≤ 38 years with BMI ≤ 30 kg/m², basal FSH < 12 mIU/mL, and 6–15 follicles ≥ 14 mm on trigger day. Cycles used depot GnRHa, long GnRHa, or GnRH antagonist protocols. Patients were stratified by DFP: <30%, 30%–60%, ≥ 60%. Outcomes included oocyte maturation rate and low maturation rate (< 40%). Multivariate linear regression and binary logistic regression were used for adjusted analyses, with P < 0.05 considered significant. RESULTS Baseline characteristics were balanced across DFP subgroups within each protocol. Overall, DFP was not significantly associated with oocyte maturation rate across the three COH protocols (P > 0.05). Only depot GnRHa ICSI cycles showed significantly lower maturation in the DFP ≥ 60% group versus lower DFP groups (P 0.05). ICSI was associated with higher risk of low maturation (P < 0.001), while greater oocyte yield, older age, and depot/long GnRHa protocols were associated with lower risk (all P < 0.05). COH protocol type significantly affected maturation outcomes (P < 0.05). CONCLUSION Excessively delaying hCG trigger to increase DFP does not improve oocyte maturation across the three main COH protocols. Earlier trigger may better preserve oocyte quality. Trigger timing should be individualized and protocol-specific rather than relying solely on follicle size criteria. COH protocol Follicle diameter IVF/ICSI Oocyte maturation rate Trigger time Introduction The determination of optimal trigger timing during controlled ovarian hyperstimulation (COH) remains a significant clinical challenge in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles 1 – 3 . A critical concern is the presence of immature oocytes within follicles measuring ≥ 14 mm in diameter at the time of trigger, which reduces oocyte utilization efficiency and may consequently compromise cumulative live birth rates 4 . Although the biological mechanisms underlying oocyte immaturity have been investigated 5 – 7 , including advanced maternal age, diminished oocyte quality, obesity, or insufficient trigger dosage, clinical factors influencing maturation rates are less frequently reported. The dominant follicular proportion (DFP), defined as the percentage of follicles ≥ 18 mm among all follicles ≥ 14 mm on the trigger day, has been proposed as a practical indicator for determining trigger timing. However, recent evidence suggests that excessively delayed triggering, which may be reflected by an elevated DFP, can adversely affect pregnancy outcomes 4 , 8 . For instance, among young normal responders undergoing the depot gonadotropin-releasing hormone agonist (GnRHa) protocol, an increased DFP has been associated with reduced oocyte developmental potential, fewer usable blastocysts, and lower cumulative pregnancy rates 4 . Similarly, in patients classified as POSEIDON Group 3, maintaining a DFP ≤ 40% by avoiding delayed triggering has been shown to be essential for achieving optimal laboratory and clinical outcomes 8 . Furthermore, the existing evidence regarding the impact of delaying hCG triggering and prolonging ovarian stimulation on oocyte quality and clinical outcomes remains inconsistent. Some studies demonstrate that this approach can lead to larger oocytes with more mature cytoplasm and potentially improved developmental competence, which may positively influence clinical results. In contrast, other studies report that delaying oocyte retrieval does not increase the number of mature oocytes or the clinical pregnancy rate and could even compromise embryo quality 9 . Additionally, several studies have observed no clear correlation between oocyte size and maturation or fertilization rates 10 – 13 . These heterogeneous findings may be attributed to variations across studies in controlled ovarian hyperstimulation protocols, patient baseline characteristics, methods for measuring oocyte diameter, insemination methods, and clinical outcomes. Nevertheless, the applicability of these findings across different COH protocols remains uncertain, particularly in clinical settings such as China, where the depot GnRHa protocol, the long GnRHa protocol, and the GnRH antagonist protocol represent the three most commonly used protocols 14 . Given their distinct pharmacological mechanisms, it is plausible that the relationship between DFP and oocyte maturation may vary across protocols. Therefore, this study aims to investigate the association between excessively delayed triggering and oocyte maturation rates, including the incidence of low maturation rate, across the three predominant COH protocols in China. The findings are intended to provide protocol-specific insights that support more individualized and evidence-based timing of trigger administration. Materials and Methods Study design and population This was a large-sample, non-interventional, retrospective cohort study conducted at a single center. A total of 9,319 women undergoing their first fresh IVF or ICSI cycle between January 2021 and January 2024 at the Reproductive Medicine Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, were included. The inclusion criteria were: (1) female age ≤ 38 years; (2) body mass index (BMI) ≤ 30 kg/m²; (3) serum basal follicle-stimulating hormone (FSH) level < 12 mIU/mL measured on menstrual cycle days 2–5; and (4) the presence of 6 to 15 follicles with a diameter ≥ 14 mm on transvaginal ultrasound on the day of human chorionic gonadotropin (hCG) administration. Exclusion criteria comprised: (1) oocyte donation or frozen oocyte cycles; (2) previous IVF/ICSI treatment; and (3) a discrepancy of more than 6 between the number of oocytes retrieved and the ultrasound-derived count of follicles ≥ 14 mm. The study was approved by the Ethics Committee of Tongji Hospital. All of the participants provided informed written consent. Controlled ovarian hyperstimulation protocols Patients utilized either the depot GnRHa protocol, the long GnRHa protocol, or the GnRH antagonist protocol. The selection of an individualized COH protocol was based on multiple factors, including female age, ovarian reserve function, and response to a prior ovulation induction or intrauterine insemination. For a standard depot GnRHa protocol, a single 3.75 mg long-acting GnRH agonist (Diphereline; Beaufour Ipsen, France) is administered on day 2 of the menstrual cycle. For a conventional long GnRHa protocol, 0.1 mg short-acting GnRH agonist (Diphereline; Beaufour Ipsen, France) is injected subcutaneously daily from Day 21 of the previous menstrual cycle (mid-luteal phase). The efficacy of pituitary suppression is assessed at 28 days for the depot GnRHa protocol and 14 days for the long GnRHa protocol. The presence of basal follicular diameter < 5 mm, serum luteinizing hormone (LH) level < 5 mIU/mL, serum estradiol (E2) level < 50 pg/mL, and endometrial thickness < 5 mm is regarded as success of downregulation. Subsequently, daily subcutaneous injections of rhFSH (Gonal-F; Serono, Switzerland) ranging from 75 to 300 IU are administered based on follicular development. The GnRH antagonist protocol typically initiates daily administration of 75–300 IU rhFSH (Gonal-F; Serono, Switzerland) on day 2 of the menstrual cycle. GnRH antagonist (Cetrorelix, 0.25 mg) is administered on day 6 of the cycle, and a combination of rhFSH and GnRH antagonist is used until the trigger day. Oocyte retrieval and insemination When at least two or three follicles with a diameter larger than 18 mm are observed, 10,000 IU recombinant hCG (Livaon Pharmaceutical Group Inc., China) was administered for trigger. On the day of hCG trigger, the number of dominant follicles with a diameter ≥ 18 mm and the number of large follicles with a diameter ≥ 14 mm are documented through transvaginal ultrasound examination. After 36–37 hours, oocytes are retrieved under the guide of transvaginal ultrasound. Subsequently, the MII oocytes are inseminated using either IVF or ICSI. Main outcomes Oocyte maturation rate is defined as the proportion of MII oocytes among the total number of oocytes retrieved. Low oocyte maturation rate (LOMR) is defined as an oocyte maturation rate below 40%. Statistics All statistical analyses were conducted using SPSS software (version 25.0; IBM Corp., Chicago, IL, USA). Participants were stratified into three groups based on DFP on the trigger day: Group A (DFP < 30%), Group B (30%≤DFP < 60%), and Group C (DFP ≥ 60%). Categorical variables are presented as numbers and percentages (%), and group differences were examined using Pearson’s chi-square test. Continuous variables are expressed as mean ± standard deviation (SD) and were compared across groups using one-way analysis of variance (ANOVA), with post‑hoc pairwise comparisons adjusted by the Bonferroni method. To evaluate the association between DFP groups and oocyte maturation rate across different COH protocols, multivariate linear regression models were fitted, adjusting for relevant confounding factors. Similarly, the relationship between DFP groups and the occurrence of a low oocyte maturation rate was assessed using binary logistic regression models, stratified by COH protocol. In both regression frameworks, adjusted marginal means with 95% confidence intervals (CIs) were estimated for each combination of COH protocol and DFP group. Statistical significance was defined as a two‑tailed P ‑value < 0.05. For post‑hoc pairwise comparisons following ANOVA, a Bonferroni‑adjusted P‑value < 0.017 was considered significant. Results A total of 9,319 fresh IVF/ICSI cycles were included in the analysis. Among them, 4,530 followed the depot GnRHa protocol, 2,737 the long GnRHa protocol and 2,052 the GnRH antagonist protocol. The clinical characteristics of patients undergoing three different COH protocols were presented in Table 1 (the depot GnRHa protocol), Table 2 (the long GnRHa protocol), and Table 3 (the GnRH antagonist protocol). The majority of baseline characteristics, including infertility type, duration of infertility, female age, BMI, AFC, basal serum FSH and AMH levels, were well balanced across DFP subgroups within each protocol. No statistically significant association was observed between increasing DFP and oocyte maturation rates across the three COH protocols (P>0.05). An exception was noted for ICSI cycles utilizing the depot GnRHa protocol, where Group C demonstrated a significantly lower maturation rate than both Group A and Group B (P<0.05). Table 1 Baseline characteristics of patients using depot GnRH agonist protocols DFP < 30% 30 – 60% ≥ 60% P value No. of cycles 824 2862 844 - Infertility type Primary 550 1854 555 0.554 Secondary 274 1008 289 Infertility duration(years) 3.34±2.24 3.45±2.27 3.45±2.28 0.484 Female age (years) 29.69±3.38 29.68±3.35 29.81±3.30 0.596 BMI (kg/m 2 ) 21.71±2.57 21.94±2.77 21.91±2.69 0.105 AFC 16.57±6.23 & 16.01±5.66 & 15.29±5.28 & <0.001 Basal FSH (mIU/mL) 7.11±1.49 7.16±1.51 7.14±1.63 0.722 AMH (ng/mL） 6.70±4.31 6.48±4.47 5.93±3.54 & 0.001 Gn dosage (IU) 2320.11±713.64 2329.53±711.76 2407.56±714.86 & 0.012 Gn duration (days) 11.38±1.95 & 11.18±1.89 11.08±1.76 0.003 Gn dosage per day (IU/day) 204.15±53.55 208.53±53.69 217.15±54.66 & <0.001 E2 on hCG day (pg/mL) 2366.95±1171.46 2360.68±1129.23 2404.98±1312.29 0.635 E2/number of large follicles 201.51±93.36 & 214.70±94.80 & 242.68±124.56 & <0.001 P on hCG day (ng/mL) 0.82±0.46 0.84±0.44 0.92±0.60 & 1.5 nmol/L (%) 8.17(65/796) 7.11(198/2786) 9.42(77/817) 0.081 No. of large follicles of hCG day 11.86±2.54 & 11.12±2.50 & 10.06±2.46 & <0.001 DFP (%) 22.14±5.71 & 43.51±8.17 & 70.19±9.35 & <0.001 No. of oocyte retrieval 13.06±3.72 & 12.27±3.70 & 11.35±3.59 & <0.001 No. of MII retrieval IVF 11.12±3.68 & 10.63±3.60 & 9.87±3.59 & <0.001 ICSI 10.62±3.56 & 9.70±3.55 & 8.73±3.41 & <0.001 Oocyte maturation rate (%) IVF 85.77±14.28 87.09±14.51 87.93±15.49 0.053 ICSI 80.08±17.01 78.52±16.89 75.41±18.99 & 0.007 Note: P < 0.05 and P ’ < 0.017 (multiple comparisons with Bonferroni correction) indicate statistically significant differences. * a statistically significant difference between two groups; & statistically significant differences between this group and the other two groups ( P ’ < 0.017). DFP, dominant follicular proportions; BMI, body mass index; AFC, antral follicle count; FSH. Follicle-stimulating hormone; AMH, anti-Mueller hormone; Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin; P, progesterone; MII, metaphase II; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection. Table 2 Baseline characteristics of patients using long GnRH agonist protocols DFP < 30% 30 – 60% ≥ 60% P value No. of cycles 235 1535 967 - Infertility type Primary 162 951 612 0.116 Secondary 73 584 355 Infertility duration(years) 3.48±2.59 3.44±2.42 3.60±2.60 0.340 Female age (years) 30.15±3.77 30.12±3.77 30.24±3.83 0.728 BMI (kg/m 2 ) 21.28±2.73 21.54±2.71 21.63±2.79 0.222 AFC 13.97±4.74 13.80±5.24 14.32±5.74 0.067 Basal FSH (mIU/mL) 7.25±1.60 7.34±1.53 7.24±1.55 0.220 AMH (ng/mL） 5.17±3.42 4.95±3.00 5.03±3.70 0.583 Gn dosage (IU) 2150.00±703.98 2157.62±644.81 2126.97±642.15 0.514 Gn duration (days) 10.07±1.58 10.07±1.49 9.99±1.50 0.376 Gn dosage per day (IU/day) 211.39±50.22 212.69±49.01 211.73±49.91 0.861 E2 on hCG day (pg/mL) 3513.25±1600.42 3589.42±1480.10* 3758.98±1718.00* 0.017 E2/number of large follicles 314.07±128.24& 339.11±118.00& 387.18±156.54& 1.5 nmol/L (%) 7.83(18/230) 6.32(95/1502)* 9.88(92/931)* 0.006 No. of large follicles of hCG day 11.32±2.54 & 10.63±2.53 & 9.75±2.35 & <0.001 DFP (%) 22.53±5.84 & 45.55±8.00 & 72.46±10.66 & <0.001 No. of oocyte retrieval 12.47±3.76 11.97±3.63 11.43±3.53 & <0.001 No. of MII retrieval IVF 10.79±3.89 10.38±3.64 9.90±3.46 & 0.005 ICSI 9.43±3.41 8.92±3.43 8.83±3.54 0.394 Oocyte maturation rate (%) IVF 87.62±13.92 87.72±15.16 88.11±0.14 0.853 ICSI 75.16±18.26 73.12±18.75 73.05±18.74 0.640 Note: P < 0.05 and P ’ < 0.017 (multiple comparisons with Bonferroni correction) indicate statistically significant differences. * a statistically significant difference between two groups; & statistically significant differences between this group and the other two groups ( P ’ < 0.017). DFP, dominant follicular proportions; BMI, body mass index; AFC, antral follicle count; FSH. Follicle-stimulating hormone; AMH, anti-Mueller hormone; Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin; P, progesterone; MII, metaphase II; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection. Table 3 Baseline characteristics of patients using GnRH antagonist protocols DFP < 30% 30 – 60% ≥ 60% P value No. of cycles 368 1193 491 - Infertility type Primary 236 755 313 0.952 Secondary 132 438 178 Infertility duration(years) 3.23±2.35 3.43±2.44 3.58±2.49 0.136 Female age (years) 30.58±3.62 30.73±3.98 30.73±3.89 0.800 BMI (kg/m 2 ) 21.59±2.60 21.82±2.76 21.81±2.71 0.336 AFC 11.40±7.09 11.22±6.77 10.09±6.63 & 0.003 Basal FSH (mIU/mL) 7.58±1.82 7.56±1.74 7.64±1.86 0.705 AMH (ng/mL） 4.26±3.58 4.15±3.48 * 3.68±3.43 * 0.024 Gn dosage (IU) 2200.99±632.87 2190.41±579.08 * 2298.31±614.62 * 0.003 Gn duration (days) 9.36±1.72 9.35±1.43 9.40±1.38 0.801 Gn dosage per day (IU/day) 234.51±49.37 233.74±47.83 243.29±49.12 & 0.001 E2 on hCG day (pg/mL) 2666.15±1382.47 2585.12±1267.12 2589.96±1307.15 0.573 E2/number of large follicles 267.38±119.73 272.39±111.17 295.97±123.72 & 1.5 nmol/L (%) 6.42(23/358) 8.10(94/1161) 12.53(60/479)& 0.003 No. of large follicles of hCG day 10.05±2.73 & 9.54±2.58 & 8.76±2.20 & <0.001 DFP (%) 21.37±6.79 & 44.43±8.05 & 71.33±10.07 & <0.001 No. of oocyte retrieval 10.82±3.87 & 10.24±3.59 & 9.57±3.61 & <0.001 No. of MII retrieval IVF 9.39±3.75 & 8.84±3.51 8.39±3.55 0.004 ICSI 8.55±3.39 8.03±3.41 7.16±3.13 & 0.006 Oocyte maturation rate (%) IVF 87.02±15.47 87.06±16.11 87.39±16.32 0.943 ICSI 79.50±17.21 78.12±18.88 75.79±21.79 0.331 Note: P < 0.05 and P ’ < 0.017 (multiple comparisons with Bonferroni correction) indicate statistically significant differences. * a statistically significant difference between two groups; & statistically significant differences between this group and the other two groups ( P ’ < 0.017). GnRH, gonadotropin-releasing hormone; DFP, dominant follicular proportions; BMI, body mass index; AFC, antral follicle count; FSH. Follicle-stimulating hormone; AMH, anti-Mueller hormone; Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin; P, progesterone; MII, metaphase II; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection. As illustrated in Table 4 , a multiple linear regression model has been employed to demonstrate the relationship between various clinical baseline factors and oocyte maturation rate. Interestingly, DFP showed no significant association with oocyte maturation rate ( P >0.05). Female age was positively correlated with oocyte maturation rate ( P =0.010). In contrast, the following factors were negatively correlated with oocyte maturation rate, including ICSI ( P <0.001), number of oocytes retrieved ( P =0.003), primary infertility ( P =0.024), infertility duration ( P =0.036), and use of the long GnRHa protocol (with depot GnRHa protocol as reference, P =0.013). After adjustment for confounders, the adjusted marginal means of DFP groups were comparable ( Table S1 , P =0.794), whereas significant differences were observed among COH protocols ( Table S2 , P =0.044). Table 4. Multivariate linear regression of COH protocol, DFP, and oocyte maturation rate β±standard error standardized β’ t value P value Infertility type Primary -0.009±0.004 -0.025 -2.264 0.024 Secondary REF Infertility duration -0.002±0.001 -0.023 -2.099 0.036 Female age 0.001±0.001 0.031 2.586 0.010 BMI 0±0.001 0.005 0.443 0.658 Basal FSH level 0.001±0.001 0.013 1.137 0.255 COH protocol GnRH antagonist -0.005±0.005 -0.014 -1.146 0.252 long GnRH agonist -0.011±0.004 -0.029 -2.484 0.013 depot GnRH agonist REF ln (Gn dosage per day) 0.003±0.008 0.005 0.403 0.687 Insemination method ICSI -0.101±0.004 -0.275 -25.309 < 0.001 IVF REF DFP DFP ≥ 60% -0.004±0.006 -0.010 -0.659 0.510 30% ≤ DFP < 60% -0.002±0.005 -0.005 -0.349 0.727 DFP < 30% REF No. of oocyte retrieved -0.002±0.001 -0.034 -2.995 0.003 Note: REF, reference; BMI, body mass index; FSH, follicle-stimulating hormone; COH, controlled oocyte hyperstimulation; Gn, gonadotropin; ICSI, intracytoplasmic sperm injection; IVF, in vitro fertilization; DFP, dominant follicular proportions. P <0.05 indicates statistically significant differences. Table S1 Marginal mean of DFP in the linear regression model of oocyte maturation rate DFP low number of oocytes retrieved Before adjustment a After adjustment b DFP ≥ 60% 84.13 (83.42, 84.84) 81.93 (81.17, 82.68) 30% ≤ DFP < 60% 84.19 (83.74, 84.65) 82.14 (81.62, 82.66) DFP < 30% 84.00 (83.10, 84.90) 82.32 (81.37, 83.27) P c 0.931 0.794 a unadjusted marginal means (95% confidence intervals). b marginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes. c Chi-square tests between pairwise comparisons based on marginal means. Table S2 Marginal mean of COH protocol in the linear regression model of oocyte maturation rate COH protocol oocyte maturation rate Before adjustment a After adjustment b GnRH antagonist 84.60 (83.85, 85.34) 82.12 (81.30, 82.94) long GnRH agonist 83.73 (83.09, 84.38) 81.60 (80.87, 82.33) depot GnRH agonist 84.18 (83.68, 84.69) 82.66 (82.07, 83.26) P c 0.224 0.044 a unadjusted marginal means (95% confidence intervals). b marginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes. c Chi-square tests between pairwise comparisons based on marginal means. LOMR was defined as an oocyte maturation rate below 40%. A binary logistic regression model was constructed to identify independent factors associated with LOMR ( Table 5 ). Results indicated that DFP was not significantly associated with LOMR ( P >0.05). Compared with IVF, ICSI was associated with an increased risk of LOMR ( P <0.001). Interestingly, however, a higher number of oocytes retrieved ( P <0.001), advanced maternal age ( P =0.024), and the use of depot GnRHa and long GnRHa protocols ( P =0.006) were associated with a reduced risk of LOMR. Similarly, after adjusting for confounders, the adjusted marginal means did not differ significantly across DFP groups ( Table S3 , P >0.05), but did differ significantly among COH protocols ( Table S4 , P =0.028). Table 5. Binary logistic regression of COH protocol, DFP, and low oocyte maturation rate OR 95% CI P value Infertility type Primary 1.051 0.736-1.500 0.786 Secondary REF Infertility duration 1.044 0.980-1.112 0.186 Female age 0.949 0.906-0.993 0.024 BMI 1.055 1.000-1.114 0.052 Basal FSH level 1.002 0.909-1.105 0.968 COH protocol GnRH antagonist 1.324 0.886-1.979 0.172 long GnRH agonist 1.632 1.153-2.309 0.006 depot GnRH agonist REF ln (Gn dosage per day) 0.690 0.365-1.303 0.253 Insemination method ICSI 3.351 2.462-4.561 < 0.001 IVF REF DFP DFP ≥ 60% 1.368 0.820-2.282 0.230 30% ≤ DFP < 60% 1.121 0.701-1.794 0.633 DFP < 30% REF No. of oocyte retrieved 0.924 0.886-0.965 < 0.001 Note: OR, odd ratio; REF, reference; CI, confidence interval; BMI, body mass index; FSH, follicle-stimulating hormone; COH, controlled oocyte hyperstimulation; Gn, gonadotropin; DFP, dominant follicular proportions. Table S3 Marginal mean of DFP in the logistic regression model of low oocyte maturation rate DFP low number of oocytes retrieved Before adjustment a After adjustment b DFP ≥ 60% 0.024 (0.019, 0.031) 0.027 (0.020, 0.036) 30% ≤ DFP < 60% 0.019 (0.016, 0.023) 0.022 (0.018, 0.028) DFP < 30% 0.019 (0.013, 0.027) 0.020 (0.013, 0.030) P c 0.328 0.407 a unadjusted marginal means (95% confidence intervals). b marginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes. c Chi-square tests between pairwise comparisons based on marginal means. Table S4 Marginal mean of COH protocol in the logistic regression model of low oocyte maturation rate COH protocol low number of oocytes retrieved Before adjustment a After adjustment b GnRH antagonist 0.023 (0.017, 0.030) 0.023 (0.017, 0.033) long GnRH agonist 0.024 (0.019, 0.031) 0.029 (0.022, 0.038) depot GnRH agonist 0.016 (0.013, 0.021) 0.018 (0.013, 0.023) P c 0.041 0.028 a unadjusted marginal means (95% confidence intervals). b marginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes. c Chi-square tests between pairwise comparisons based on marginal means. Comment Principal Findings In this large retrospective cohort of 9,319 fresh IVF/ICSI cycles, dominant follicular proportion (DFP) on the day of hCG trigger was not significantly associated with oocyte maturation rate or the risk of low oocyte maturation rate across the three most commonly used controlled ovarian hyperstimulation (COH) protocols in China. The only exception was that in intracytoplasmic sperm injection (ICSI) cycles using the depot gonadotropin-releasing hormone agonist (GnRHa) protocol, a DFP ≥60% was associated with a significantly lower oocyte maturation rate. After adjustment for confounders, COH protocol type was significantly associated with oocyte maturation outcomes, whereas DFP group was not. Results in the Context of What is Known Previous studies have yielded heterogeneous results regarding the relationship between follicle size, delayed hCG trigger, and oocyte developmental competence 1,9,10,15 . Some investigations supported a positive correlation between follicular diameter and oocyte maturity or embryo quality 16,17,18,19 , leading to clinical practice of delaying trigger to obtain more large follicles. Conversely, other work demonstrated that prolonged stimulation or excessively high DFP may compromise oocyte quality and pregnancy outcomes 4,7,8,20,21 . Our findings are consistent with studies showing that increasing follicle size to elevate DFP does not enhance oocyte maturation and may even be harmful 7,20,21 . Most prior studies focused on a single COH protocol or included smaller samples 4,8 , whereas the present large‑scale comparison across three major regimens helps explain inconsistent conclusions in the literature 10,13 . Clinical Implications Pursuing excessively high DFP by delaying hCG trigger does not improve oocyte maturation and may reduce oocyte quality in selected clinical scenarios. These findings challenge the conventional size‑centric criteria for trigger timing 1,2,7,15 and support individualized, protocol‑specific decision‑making. Earlier trigger may better safeguard oocyte quality across all three COH protocols. The depot GnRHa protocol was associated with more favorable oocyte maturation outcomes, consistent with prior evidence suggesting benefits of this regimen in normal responders 14 . Prospective randomized trials are required to confirm these observations before widespread clinical implementation. Research Implications Key unanswered questions include the generalizability of these findings to older women, poor ovarian responders, and patients at risk of ovarian hyperstimulation syndrome. Future research should establish protocol‑specific DFP thresholds for trigger timing in randomized controlled designs. Long‑term studies evaluating cumulative live birth rates associated with different DFP strata are needed. Further investigation is also warranted to clarify how varying gonadotropin types and dosages modify the relationship between DFP and oocyte maturation. Strengths and Limitations Strengths include the very large single‑center sample, strict inclusion criteria that balanced baseline characteristics across subgroups, and direct comparison of the three dominant COH protocols used in China 14 . Standardized outcome definitions and multivariable adjustment enhance the robustness of analyses. Limitations include the retrospective design, which carries inherent risk of residual confounding. The study was restricted to young normal responders, limiting generalizability. Ultrasound measurement of follicular diameter is subjective, introducing potential variability in DFP assessment. Cumulative pregnancy outcomes were not available within the study timeframe, and variations in gonadotropin preparations and dosing may have influenced results. Conclusion In summary, across the three predominant COH protocols, excessively postponing the hCG trigger to pursue a greater number of larger follicles does not improve oocyte maturation rates. In certain clinical scenarios, earlier triggering may be considered to safeguard oocyte quality. These insights support a more nuanced, protocol-informed approach to trigger timing, moving beyond size-centric criteria toward individualized management. Declarations Ethics approval and consent to participate: This study was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. All procedures were conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants. Clinical trial number not applicable. Disclosure Statement : The authors declare no competing interests. Funding Statement: This study was supported by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDC0200000), the Fertility Research Program of Young and Middle-aged Physicians in 2024 (No. BJHPA-2024-SHZHYXZHQNYJ-012), and the Hubei Province Health and Family Planning Scientific Research Project (WJ2023M117). Author Contribution S.L. performed the investigation, conducted the statistical analysis, and drafted the manuscript. J.B. contributed to study conceptualization, acquired funding, and revised the manuscript. H.S. participated in manuscript drafting. L.J. contributed to project administration and data curation. Y.L. participated in the investigation and supervised the study. C.L. contributed to data curation. K.Q. contributed to study conceptualization, acquired funding, supervised the study, and critically revised the manuscript. All authors reviewed and approved the final manuscript. Data Availability The data analyzed in this study are subject to institutional restrictions and are therefore not publicly available. Requests for access can be directed to the corresponding author. References Lin HY, Li Y, Wang WJ, Qiu Q, Zhang QX, Li Y. Role of the proportion of dominant follicles in patients with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer. Chinese Med journal Jun. 2019;20(12):1448–53. Mochtar MH, Custers IM, Koks CA, et al. Timing oocyte collection in GnRH agonists down-regulated IVF and ICSI cycles: a randomized clinical trial. Hum Reprod (Oxford England). May 2011;26(5):1091–6. Xie Q, Ni D, Chen S, et al. Meta-analysis of trigger timing in normal responders undergoing GnRH antagonist ovarian hyperstimulation protocol. Journal ovarian research Mar. 2024;5(1):56. Su H, Lai Y, Li J, et al. Increasing dominant follicular proportion negatively associated with good clinical outcomes in normal ovarian responders using the depot GnRH agonist protocol: a large-sample retrospective analysis. Journal ovarian research Apr. 2022;13(1):44. Orvieto R. A simplified universal approach to COH protocol for IVF: ultrashort flare GnRH-agonist/GnRH-antagonist protocol with tailored mode and timing of final follicular maturation. Journal ovarian research Nov. 2015;4:8:69. Li Y, Li Y, Lai Q et al. Oct. Comparison between a GnRH agonist and a GnRH antagonist protocol for the same patient undergoing IVF. Journal of Huazhong University of Science and Technology Medical sciences = Hua zhong ke ji da xue xue bao Yi xue Ying De wen ban = Huazhong keji daxue xuebao Yixue Yingdewen ban . 2008;28(5):618 – 20. Kolibianakis EM, Albano C, Camus M, Tournaye H, Van Steirteghem AC, Devroey P. Prolongation of the follicular phase in in vitro fertilization results in a lower ongoing pregnancy rate in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertility sterility Jul. 2004;82(1):102–7. Xie Q, Jiang W, Wei Y, et al. Increasing dominant follicular proportion was associated with adverse IVF/ICSI outcomes in low-prognosis women undergoing GnRH antagonist protocol: a retrospective cohort study. Journal ovarian research Aug. 2024;31(1):179. Li Y, Li RQ, Ou SB, et al. Association between the proportion of dominant follicles and oocyte developmental competence. Journal Assist Reprod genetics Dec. 2014;31(12):1599–604. Wang W, Zhang XH, Wang WH, et al. The time interval between hCG priming and oocyte retrieval in ART program: a meta-analysis. J Assist Reprod Genet. Sep 2011;28(10):901–10. European and Middle East Orgalutran Study Group. Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Hum Reprod Apr. 2001;16(4):644–51. Jiang L, Ji L, Song J, Qian K. The effect of serum vitamin D levels in couples on embryo development and clinical outcomes. Reproductive Biomed online May. 2019;38(5):699–710. Lee TF, Lee RK, Hwu YM, Chih YF, Tsai YC, Su JT. Relationship of follicular size to the development of intracytoplasmic sperm injection-derived human embryos. Taiwanese J Obstet & gynecology Sep. 2010;49(3):302–5. Xu B, Geerts D, Hu S, et al. The depot GnRH agonist protocol improves the live birth rate per fresh embryo transfer cycle, but not the cumulative live birth rate in normal responders: a randomized controlled trial and molecular mechanism study. Human reproduction (Oxford, England) . Jun. 2020;1(6):1306–18. Hu X, Luo Y, Huang K, et al. New Perspectives on Criteria for the Determination of HCG Trigger Timing in GnRH Antagonist Cycles. Medicine May. 2016;95(20):e3691. Rosen MP, Shen S, Dobson AT, Rinaudo PF, McCulloch CE, Cedars MI. A quantitative assessment of follicle size on oocyte developmental competence. Fertility sterility Sep. 2008;90(3):684–90. Triwitayakorn A, Suwajanakorn S, Pruksananonda K, Sereepapong W, Ahnonkitpanit V. Correlation between human follicular diameter and oocyte outcomes in an ICSI program. Journal Assist Reprod genetics Apr. 2003;20(4):143–7. Mehri S, Levi Setti PE, Greco K, Sakkas D, Martinez G, Patrizio P. Correlation between follicular diameters and flushing versus no flushing on oocyte maturity, fertilization rate and embryo quality. J Assist Reprod Genet. Jan 2014;31(1):73–7. Braga DP, Bonetti TC, da Silva ID, Setti AS, Iaconelli AJ, Borges EJ. The developmental competence of oocytes retrieved from the leading follicle in controlled ovarian stimulated cycles. International J fertility & sterility Jan. 2013;6(4):272–7. Chen Y, Zhang Y, Hu M, Liu X, Qi H. Timing of human chorionic gonadotropin (hCG) hormone administration in IVF/ICSI protocols using GnRH agonist or antagonists: a systematic review and meta-analysis. Gynecological endocrinology: official J Int Soc Gynecol Endocrinology Jun. 2014;30(6):431–7. Nogueira D, Friedler S, Schachter M, Raziel A, Ron-El R, Smitz J. Oocyte maturity and preimplantation development in relation to follicle diameter in gonadotropin-releasing hormone agonist or antagonist treatments. Fertil Steril. Mar 2006;85(3):578–83. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 28 Apr, 2026 Reviewers invited by journal 23 Apr, 2026 Editor assigned by journal 20 Apr, 2026 Submission checks completed at journal 20 Apr, 2026 First submitted to journal 12 Apr, 2026 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 Advisory Board 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-9398415","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":633757278,"identity":"582586a5-71cb-42a0-9463-c25bd3d42d56","order_by":0,"name":"Seereipanha Ly","email":"","orcid":"","institution":"Tongji Medical College, Huazhong University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Seereipanha","middleName":"","lastName":"Ly","suffix":""},{"id":633757280,"identity":"9382feb1-95c7-4161-8fa1-b2f770bf55fb","order_by":1,"name":"Jian Bai","email":"","orcid":"","institution":"Tongji Medical College, Huazhong University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Jian","middleName":"","lastName":"Bai","suffix":""},{"id":633757281,"identity":"aafd90af-6c1a-43c3-a013-5b738c85c46d","order_by":2,"name":"Houming Su","email":"","orcid":"","institution":"Guangxi Academy of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Houming","middleName":"","lastName":"Su","suffix":""},{"id":633757282,"identity":"27e7d619-6ada-415b-aae3-41e26b8d1990","order_by":3,"name":"Liu Jiang","email":"","orcid":"","institution":"Tongji Medical College, Huazhong University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Liu","middleName":"","lastName":"Jiang","suffix":""},{"id":633757286,"identity":"64093908-5977-457d-b8df-f69093f02878","order_by":4,"name":"Yan Li","email":"","orcid":"","institution":"Tongji Medical College, Huazhong University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Yan","middleName":"","lastName":"Li","suffix":""},{"id":633757288,"identity":"4a8a54ef-ccd1-4953-88c3-47bb5932835e","order_by":5,"name":"Chenyuan Liu","email":"","orcid":"","institution":"Tongji Medical College, Huazhong University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Chenyuan","middleName":"","lastName":"Liu","suffix":""},{"id":633757289,"identity":"9aa3c64f-6f5e-4178-a311-2e794a45677f","order_by":6,"name":"Kun Qian","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIie3PuwrCMBSA4VMEuwRcI95eoaUgPk6CoIu6CILQoSA4BV19DRdXI4G6RGelDk5ODk7iJCYWdWrtKJh/OLSHfiQFMJl+MKwHAagCSPWEnksnE/GQJjwzUVGmT+CQgRRn3dXu6B/aS2vDc5fyggb2aIHBPySSEu41GyQ8dRlsibpYRAMUDjCEp0RSxZ06JnmhiHRiojdWIL6Qu2ijN6md00lJEzoW5EMwSidFdvYadCJcxqXDJYq8MWr11d8lE7zuuPvbVdTsmXSPQxZVpraY7y5+MnmyeHLgFgPI6xeSCl6kEKhx+/KpyWQy/WUPC8BX80NmyosAAAAASUVORK5CYII=","orcid":"","institution":"Tongji Medical College, Huazhong University of Science and Technology","correspondingAuthor":true,"prefix":"","firstName":"Kun","middleName":"","lastName":"Qian","suffix":""}],"badges":[],"createdAt":"2026-04-13 04:08:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9398415/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9398415/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108493716,"identity":"6923f528-5aeb-4812-9d12-bc179ed0be49","added_by":"auto","created_at":"2026-05-05 10:01:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":630272,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9398415/v1/dcb34467-05ec-4e52-9bb2-f746645d03fd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Delayed hCG Trigger Does Not Improve Oocyte Maturation Rate: Evidence from 9,319 IVF/ICSI Cycles Using Three Controlled Ovarian Hyperstimulation Protocols","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe determination of optimal trigger timing during controlled ovarian hyperstimulation (COH) remains a significant clinical challenge in \u003cem\u003ein vitro\u003c/em\u003e fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles \u003csup\u003e\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. A critical concern is the presence of immature oocytes within follicles measuring\u0026thinsp;\u0026ge;\u0026thinsp;14 mm in diameter at the time of trigger, which reduces oocyte utilization efficiency and may consequently compromise cumulative live birth rates \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Although the biological mechanisms underlying oocyte immaturity have been investigated \u003csup\u003e\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e, including advanced maternal age, diminished oocyte quality, obesity, or insufficient trigger dosage, clinical factors influencing maturation rates are less frequently reported.\u003c/p\u003e \u003cp\u003eThe dominant follicular proportion (DFP), defined as the percentage of follicles\u0026thinsp;\u0026ge;\u0026thinsp;18 mm among all follicles\u0026thinsp;\u0026ge;\u0026thinsp;14 mm on the trigger day, has been proposed as a practical indicator for determining trigger timing. However, recent evidence suggests that excessively delayed triggering, which may be reflected by an elevated DFP, can adversely affect pregnancy outcomes \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. For instance, among young normal responders undergoing the depot gonadotropin-releasing hormone agonist (GnRHa) protocol, an increased DFP has been associated with reduced oocyte developmental potential, fewer usable blastocysts, and lower cumulative pregnancy rates \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Similarly, in patients classified as POSEIDON Group 3, maintaining a DFP\u0026thinsp;\u0026le;\u0026thinsp;40% by avoiding delayed triggering has been shown to be essential for achieving optimal laboratory and clinical outcomes \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Furthermore, the existing evidence regarding the impact of delaying hCG triggering and prolonging ovarian stimulation on oocyte quality and clinical outcomes remains inconsistent. Some studies demonstrate that this approach can lead to larger oocytes with more mature cytoplasm and potentially improved developmental competence, which may positively influence clinical results. In contrast, other studies report that delaying oocyte retrieval does not increase the number of mature oocytes or the clinical pregnancy rate and could even compromise embryo quality \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Additionally, several studies have observed no clear correlation between oocyte size and maturation or fertilization rates \u003csup\u003e\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. These heterogeneous findings may be attributed to variations across studies in controlled ovarian hyperstimulation protocols, patient baseline characteristics, methods for measuring oocyte diameter, insemination methods, and clinical outcomes.\u003c/p\u003e \u003cp\u003eNevertheless, the applicability of these findings across different COH protocols remains uncertain, particularly in clinical settings such as China, where the depot GnRHa protocol, the long GnRHa protocol, and the GnRH antagonist protocol represent the three most commonly used protocols \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Given their distinct pharmacological mechanisms, it is plausible that the relationship between DFP and oocyte maturation may vary across protocols. Therefore, this study aims to investigate the association between excessively delayed triggering and oocyte maturation rates, including the incidence of low maturation rate, across the three predominant COH protocols in China. The findings are intended to provide protocol-specific insights that support more individualized and evidence-based timing of trigger administration.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and population\u003c/h2\u003e \u003cp\u003eThis was a large-sample, non-interventional, retrospective cohort study conducted at a single center. A total of 9,319 women undergoing their first fresh IVF or ICSI cycle between January 2021 and January 2024 at the Reproductive Medicine Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, were included. The inclusion criteria were: (1) female age\u0026thinsp;\u0026le;\u0026thinsp;38 years; (2) body mass index (BMI)\u0026thinsp;\u0026le;\u0026thinsp;30 kg/m\u0026sup2;; (3) serum basal follicle-stimulating hormone (FSH) level\u0026thinsp;\u0026lt;\u0026thinsp;12 mIU/mL measured on menstrual cycle days 2\u0026ndash;5; and (4) the presence of 6 to 15 follicles with a diameter\u0026thinsp;\u0026ge;\u0026thinsp;14 mm on transvaginal ultrasound on the day of human chorionic gonadotropin (hCG) administration. Exclusion criteria comprised: (1) oocyte donation or frozen oocyte cycles; (2) previous IVF/ICSI treatment; and (3) a discrepancy of more than 6 between the number of oocytes retrieved and the ultrasound-derived count of follicles\u0026thinsp;\u0026ge;\u0026thinsp;14 mm. The study was approved by the Ethics Committee of Tongji Hospital. All of the participants provided informed written consent.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eControlled ovarian hyperstimulation protocols\u003c/h3\u003e\n\u003cp\u003ePatients utilized either the depot GnRHa protocol, the long GnRHa protocol, or the GnRH antagonist protocol. The selection of an individualized COH protocol was based on multiple factors, including female age, ovarian reserve function, and response to a prior ovulation induction or intrauterine insemination.\u003c/p\u003e \u003cp\u003eFor a standard depot GnRHa protocol, a single 3.75 mg long-acting GnRH agonist (Diphereline; Beaufour Ipsen, France) is administered on day 2 of the menstrual cycle. For a conventional long GnRHa protocol, 0.1 mg short-acting GnRH agonist (Diphereline; Beaufour Ipsen, France) is injected subcutaneously daily from Day 21 of the previous menstrual cycle (mid-luteal phase). The efficacy of pituitary suppression is assessed at 28 days for the depot GnRHa protocol and 14 days for the long GnRHa protocol. The presence of basal follicular diameter\u0026thinsp;\u0026lt;\u0026thinsp;5 mm, serum luteinizing hormone (LH) level\u0026thinsp;\u0026lt;\u0026thinsp;5 mIU/mL, serum estradiol (E2) level\u0026thinsp;\u0026lt;\u0026thinsp;50 pg/mL, and endometrial thickness\u0026thinsp;\u0026lt;\u0026thinsp;5 mm is regarded as success of downregulation. Subsequently, daily subcutaneous injections of rhFSH (Gonal-F; Serono, Switzerland) ranging from 75 to 300 IU are administered based on follicular development.\u003c/p\u003e \u003cp\u003eThe GnRH antagonist protocol typically initiates daily administration of 75\u0026ndash;300 IU rhFSH (Gonal-F; Serono, Switzerland) on day 2 of the menstrual cycle. GnRH antagonist (Cetrorelix, 0.25 mg) is administered on day 6 of the cycle, and a combination of rhFSH and GnRH antagonist is used until the trigger day.\u003c/p\u003e\n\u003ch3\u003eOocyte retrieval and insemination\u003c/h3\u003e\n\u003cp\u003eWhen at least two or three follicles with a diameter larger than 18 mm are observed, 10,000 IU recombinant hCG (Livaon Pharmaceutical Group Inc., China) was administered for trigger. On the day of hCG trigger, the number of dominant follicles with a diameter\u0026thinsp;\u0026ge;\u0026thinsp;18 mm and the number of large follicles with a diameter\u0026thinsp;\u0026ge;\u0026thinsp;14 mm are documented through transvaginal ultrasound examination. After 36\u0026ndash;37 hours, oocytes are retrieved under the guide of transvaginal ultrasound. Subsequently, the MII oocytes are inseminated using either IVF or ICSI.\u003c/p\u003e\n\u003ch3\u003eMain outcomes\u003c/h3\u003e\n\u003cp\u003eOocyte maturation rate is defined as the proportion of MII oocytes among the total number of oocytes retrieved. Low oocyte maturation rate (LOMR) is defined as an oocyte maturation rate below 40%.\u003c/p\u003e\n\u003ch3\u003eStatistics\u003c/h3\u003e\n\u003cp\u003eAll statistical analyses were conducted using SPSS software (version 25.0; IBM Corp., Chicago, IL, USA). Participants were stratified into three groups based on DFP on the trigger day: Group A (DFP\u0026thinsp;\u0026lt;\u0026thinsp;30%), Group B (30%\u0026le;DFP\u0026thinsp;\u0026lt;\u0026thinsp;60%), and Group C (DFP\u0026thinsp;\u0026ge;\u0026thinsp;60%). Categorical variables are presented as numbers and percentages (%), and group differences were examined using Pearson\u0026rsquo;s chi-square test. Continuous variables are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and were compared across groups using one-way analysis of variance (ANOVA), with post‑hoc pairwise comparisons adjusted by the Bonferroni method. To evaluate the association between DFP groups and oocyte maturation rate across different COH protocols, multivariate linear regression models were fitted, adjusting for relevant confounding factors. Similarly, the relationship between DFP groups and the occurrence of a low oocyte maturation rate was assessed using binary logistic regression models, stratified by COH protocol. In both regression frameworks, adjusted marginal means with 95% confidence intervals (CIs) were estimated for each combination of COH protocol and DFP group. Statistical significance was defined as a two‑tailed \u003cem\u003eP\u003c/em\u003e‑value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. For post‑hoc pairwise comparisons following ANOVA, a Bonferroni‑adjusted P‑value\u0026thinsp;\u0026lt;\u0026thinsp;0.017 was considered significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 9,319 fresh IVF/ICSI cycles were included in the analysis. Among them, 4,530 followed the depot GnRHa protocol, 2,737 the long GnRHa protocol and 2,052 the GnRH antagonist protocol. The clinical characteristics of patients undergoing three different COH protocols were presented in \u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e(the depot GnRHa protocol), \u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003e(the long GnRHa protocol), and \u003cstrong\u003eTable 3\u003c/strong\u003e (the GnRH antagonist protocol). The majority of baseline characteristics, including infertility type, duration of infertility, female age, BMI, AFC, basal serum FSH and AMH levels, were well balanced across DFP subgroups within each protocol. No statistically significant association was observed between increasing DFP and oocyte maturation rates across the three COH protocols (P\u0026gt;0.05). An exception was noted for ICSI cycles utilizing the depot GnRHa protocol, where Group C demonstrated a significantly lower maturation rate than both Group A and Group B (P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eTable 1 Baseline characteristics of patients using depot GnRH agonist protocols\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"106%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003eDFP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e30 \u0026ndash; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eNo. of cycles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2862\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eInfertility type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1854\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e1008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eInfertility duration(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.34\u0026plusmn;2.24\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.45\u0026plusmn;2.27\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.45\u0026plusmn;2.28\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.484\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eFemale age (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e29.69\u0026plusmn;3.38\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e29.68\u0026plusmn;3.35\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e29.81\u0026plusmn;3.30\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.596\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e21.71\u0026plusmn;2.57\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e21.94\u0026plusmn;2.77\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e21.91\u0026plusmn;2.69\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.105\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eAFC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e16.57\u0026plusmn;6.23 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e16.01\u0026plusmn;5.66 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e15.29\u0026plusmn;5.28 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eBasal FSH (mIU/mL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e7.11\u0026plusmn;1.49\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e7.16\u0026plusmn;1.51\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e7.14\u0026plusmn;1.63\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.722\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eAMH (ng/mL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e6.70\u0026plusmn;4.31\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e6.48\u0026plusmn;4.47\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e5.93\u0026plusmn;3.54 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eGn dosage (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2320.11\u0026plusmn;713.64\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2329.53\u0026plusmn;711.76\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e2407.56\u0026plusmn;714.86 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.012\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eGn duration (days)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.38\u0026plusmn;1.95 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.18\u0026plusmn;1.89\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.08\u0026plusmn;1.76\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.003\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eGn dosage per day (IU/day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e204.15\u0026plusmn;53.55\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e208.53\u0026plusmn;53.69\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e217.15\u0026plusmn;54.66 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eE2 on hCG day (pg/mL)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2366.95\u0026plusmn;1171.46\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2360.68\u0026plusmn;1129.23\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e2404.98\u0026plusmn;1312.29\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.635\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eE2/number of large follicles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e201.51\u0026plusmn;93.36 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e214.70\u0026plusmn;94.80 \u0026amp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e242.68\u0026plusmn;124.56 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eP on hCG day (ng/mL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.82\u0026plusmn;0.46\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.84\u0026plusmn;0.44\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e0.92\u0026plusmn;0.60 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eProportion of P \u0026gt; 1.5 nmol/L (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e8.17(65/796)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e7.11(198/2786)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e9.42(77/817)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eNo. of large follicles of hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.86\u0026plusmn;2.54 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.12\u0026plusmn;2.50 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e10.06\u0026plusmn;2.46 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eDFP (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e22.14\u0026plusmn;5.71 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e43.51\u0026plusmn;8.17 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e70.19\u0026plusmn;9.35 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eNo. of oocyte retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e13.06\u0026plusmn;3.72 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e12.27\u0026plusmn;3.70 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e11.35\u0026plusmn;3.59 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eNo. of MII retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.12\u0026plusmn;3.68 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e10.63\u0026plusmn;3.60 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e9.87\u0026plusmn;3.59 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e10.62\u0026plusmn;3.56 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e9.70\u0026plusmn;3.55 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e8.73\u0026plusmn;3.41 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eOocyte maturation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e85.77\u0026plusmn;14.28\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e87.09\u0026plusmn;14.51\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e87.93\u0026plusmn;15.49\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.053\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e80.08\u0026plusmn;17.01\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e78.52\u0026plusmn;16.89\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e75.41\u0026plusmn;18.99 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.007\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: \u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05 and \u003cem\u003eP\u003c/em\u003e\u0026rsquo; \u0026lt; 0.017 (multiple comparisons with Bonferroni correction) indicate statistically significant differences.\u003c/p\u003e\n\u003cp\u003e* a statistically significant difference between two groups; \u0026amp; statistically significant differences between this group and the other two groups (\u003cem\u003eP\u003c/em\u003e\u0026rsquo; \u0026lt; 0.017).\u003c/p\u003e\n\u003cp\u003eDFP, dominant follicular proportions; BMI, body mass index; AFC, antral follicle count; FSH. Follicle-stimulating hormone; AMH, anti-Mueller hormone; Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin; P, progesterone; MII, metaphase II; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection.\u003c/p\u003e\n\u003cp\u003eTable 2 Baseline characteristics of patients using long GnRH agonist protocols\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"105%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDFP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e30 \u0026ndash; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of cycles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eInfertility type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.116\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e584\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e355\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eInfertility duration(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.48\u0026plusmn;2.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3.44\u0026plusmn;2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3.60\u0026plusmn;2.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.340\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eFemale age (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e30.15\u0026plusmn;3.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e30.12\u0026plusmn;3.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e30.24\u0026plusmn;3.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.728\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e21.28\u0026plusmn;2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e21.54\u0026plusmn;2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e21.63\u0026plusmn;2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eAFC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e13.97\u0026plusmn;4.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e13.80\u0026plusmn;5.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e14.32\u0026plusmn;5.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eBasal FSH (mIU/mL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e7.25\u0026plusmn;1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.34\u0026plusmn;1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e7.24\u0026plusmn;1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eAMH (ng/mL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e5.17\u0026plusmn;3.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e4.95\u0026plusmn;3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e5.03\u0026plusmn;3.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGn dosage (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2150.00\u0026plusmn;703.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2157.62\u0026plusmn;644.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e2126.97\u0026plusmn;642.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.514\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGn duration (days)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e10.07\u0026plusmn;1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e10.07\u0026plusmn;1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e9.99\u0026plusmn;1.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.376\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGn dosage per day (IU/day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e211.39\u0026plusmn;50.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e212.69\u0026plusmn;49.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e211.73\u0026plusmn;49.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.861\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eE2 on hCG day (pg/mL)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3513.25\u0026plusmn;1600.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3589.42\u0026plusmn;1480.10*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e3758.98\u0026plusmn;1718.00*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eE2/number of large follicles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e314.07\u0026plusmn;128.24\u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e339.11\u0026plusmn;118.00\u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e387.18\u0026plusmn;156.54\u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eP on hCG day (ng/mL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.89\u0026plusmn;0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e0.92\u0026plusmn;0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.97\u0026plusmn;0.39 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eProportion of P \u0026gt; 1.5 nmol/L (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e7.83(18/230)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e6.32(95/1502)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e9.88(92/931)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of large follicles of hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.32\u0026plusmn;2.54 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e10.63\u0026plusmn;2.53 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e9.75\u0026plusmn;2.35 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eDFP (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e22.53\u0026plusmn;5.84 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e45.55\u0026plusmn;8.00 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e72.46\u0026plusmn;10.66 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of oocyte retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e12.47\u0026plusmn;3.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e11.97\u0026plusmn;3.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e11.43\u0026plusmn;3.53 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of MII retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e10.79\u0026plusmn;3.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e10.38\u0026plusmn;3.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e9.90\u0026plusmn;3.46 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e9.43\u0026plusmn;3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e8.92\u0026plusmn;3.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e8.83\u0026plusmn;3.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eOocyte maturation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e87.62\u0026plusmn;13.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e87.72\u0026plusmn;15.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e88.11\u0026plusmn;0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e75.16\u0026plusmn;18.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e73.12\u0026plusmn;18.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e73.05\u0026plusmn;18.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.640\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: \u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05 and \u003cem\u003eP\u003c/em\u003e\u0026rsquo; \u0026lt; 0.017 (multiple comparisons with Bonferroni correction) indicate statistically significant differences.\u003c/p\u003e\n\u003cp\u003e* a statistically significant difference between two groups; \u0026amp; statistically significant differences between this group and the other two groups (\u003cem\u003eP\u003c/em\u003e\u0026rsquo; \u0026lt; 0.017).\u003c/p\u003e\n\u003cp\u003eDFP, dominant follicular proportions; BMI, body mass index; AFC, antral follicle count; FSH. Follicle-stimulating hormone; AMH, anti-Mueller hormone; Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin; P, progesterone; MII, metaphase II; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection.\u003c/p\u003e\n\u003cp\u003eTable 3 Baseline characteristics of patients using GnRH antagonist protocols\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"105%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDFP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e30 \u0026ndash; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of cycles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e491\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eInfertility type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.952\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eInfertility duration(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e3.23\u0026plusmn;2.35\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3.43\u0026plusmn;2.44\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3.58\u0026plusmn;2.49\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.136\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eFemale age (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e30.58\u0026plusmn;3.62\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e30.73\u0026plusmn;3.98\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e30.73\u0026plusmn;3.89\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.800\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e21.59\u0026plusmn;2.60\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e21.82\u0026plusmn;2.76\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e21.81\u0026plusmn;2.71\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.336\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eAFC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e11.40\u0026plusmn;7.09\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e11.22\u0026plusmn;6.77\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e10.09\u0026plusmn;6.63 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.003\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eBasal FSH (mIU/mL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e7.58\u0026plusmn;1.82\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.56\u0026plusmn;1.74\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.64\u0026plusmn;1.86\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.705\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eAMH (ng/mL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e4.26\u0026plusmn;3.58\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e4.15\u0026plusmn;3.48 *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e3.68\u0026plusmn;3.43 *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.024\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGn dosage (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2200.99\u0026plusmn;632.87\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2190.41\u0026plusmn;579.08 *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2298.31\u0026plusmn;614.62 *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.003\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGn duration (days)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e9.36\u0026plusmn;1.72\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e9.35\u0026plusmn;1.43\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e9.40\u0026plusmn;1.38\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.801\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGn dosage per day (IU/day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e234.51\u0026plusmn;49.37\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e233.74\u0026plusmn;47.83\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e243.29\u0026plusmn;49.12 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eE2 on hCG day (pg/mL)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e2666.15\u0026plusmn;1382.47\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2585.12\u0026plusmn;1267.12\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e2589.96\u0026plusmn;1307.15\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.573\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eE2/number of large follicles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e267.38\u0026plusmn;119.73\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e272.39\u0026plusmn;111.17\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e295.97\u0026plusmn;123.72 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eP on hCG day (ng/mL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.88\u0026plusmn;0.45\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e0.92\u0026plusmn;0.48\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.46 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eProportion of P \u0026gt; 1.5 nmol/L (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e6.42(23/358)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e8.10(94/1161)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e12.53(60/479)\u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of large follicles of hCG day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e10.05\u0026plusmn;2.73 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e9.54\u0026plusmn;2.58 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e8.76\u0026plusmn;2.20 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eDFP (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e21.37\u0026plusmn;6.79 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e44.43\u0026plusmn;8.05 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e71.33\u0026plusmn;10.07 \u0026amp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of oocyte retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e10.82\u0026plusmn;3.87 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e10.24\u0026plusmn;3.59 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e9.57\u0026plusmn;3.61 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eNo. of MII retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e9.39\u0026plusmn;3.75 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e8.84\u0026plusmn;3.51\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e8.39\u0026plusmn;3.55\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e8.55\u0026plusmn;3.39\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e8.03\u0026plusmn;3.41\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.16\u0026plusmn;3.13 \u0026amp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33px;\"\u003e\n \u003cp\u003eOocyte maturation rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e87.02\u0026plusmn;15.47\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e87.06\u0026plusmn;16.11\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e87.39\u0026plusmn;16.32\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e79.50\u0026plusmn;17.21\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e78.12\u0026plusmn;18.88\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e75.79\u0026plusmn;21.79\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: \u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05 and \u003cem\u003eP\u003c/em\u003e\u0026rsquo; \u0026lt; 0.017 (multiple comparisons with Bonferroni correction) indicate statistically significant differences.\u003c/p\u003e\n\u003cp\u003e* a statistically significant difference between two groups; \u0026amp; statistically significant differences between this group and the other two groups (\u003cem\u003eP\u003c/em\u003e\u0026rsquo; \u0026lt; 0.017).\u003c/p\u003e\n\u003cp\u003eGnRH, gonadotropin-releasing hormone; DFP, dominant follicular proportions; BMI, body mass index; AFC, antral follicle count; FSH. Follicle-stimulating hormone; AMH, anti-Mueller hormone; Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin; P, progesterone; MII, metaphase II; IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection.\u003c/p\u003e\n\u003cp\u003eAs illustrated in \u003cstrong\u003eTable 4\u003c/strong\u003e, a multiple linear regression model has been employed to demonstrate the relationship between various clinical baseline factors and oocyte maturation rate. Interestingly, DFP showed no significant association with oocyte maturation rate (\u003cem\u003eP\u003c/em\u003e\u0026gt;0.05). Female age was positively correlated with oocyte maturation rate (\u003cem\u003eP\u003c/em\u003e=0.010). In contrast, the following factors were negatively correlated with oocyte maturation rate, including ICSI (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), number of oocytes retrieved (\u003cem\u003eP\u003c/em\u003e=0.003), primary infertility (\u003cem\u003eP\u003c/em\u003e=0.024), infertility duration (\u003cem\u003eP\u003c/em\u003e=0.036), and use of the long GnRHa protocol (with depot GnRHa protocol as reference, \u003cem\u003eP\u003c/em\u003e=0.013). After adjustment for confounders, the adjusted marginal means of DFP groups were comparable (\u003cstrong\u003eTable S1\u003c/strong\u003e, \u003cem\u003eP\u003c/em\u003e=0.794), whereas significant differences were observed among COH protocols (\u003cstrong\u003eTable S2\u003c/strong\u003e, \u003cem\u003eP\u003c/em\u003e=0.044).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4. Multivariate linear regression of COH protocol, DFP, and oocyte maturation rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026beta;\u0026plusmn;standard error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003estandardized \u0026beta;\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eInfertility type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; Primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.009\u0026plusmn;0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-2.264\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eInfertility duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.002\u0026plusmn;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-2.099\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eFemale age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.001\u0026plusmn;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e2.586\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0\u0026plusmn;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.443\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.658\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eBasal FSH level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.001\u0026plusmn;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e1.137\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.255\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eCOH protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; GnRH antagonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.005\u0026plusmn;0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-1.146\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.252\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003elong GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.011\u0026plusmn;0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-2.484\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; depot GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eln (Gn dosage per day)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0.003\u0026plusmn;0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.403\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.687\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eInsemination method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; ICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.101\u0026plusmn;0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-25.309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; IVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eDFP\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; DFP \u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.004\u0026plusmn;0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.010\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.659\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.510\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp; 30% \u0026le; DFP \u0026lt; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.002\u0026plusmn;0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.005\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.349\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.727\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eDFP \u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eREF\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eNo. of oocyte retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0.002\u0026plusmn;0.001\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-0.034\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e-2.995\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.003\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: REF, reference; BMI, body mass index; FSH, follicle-stimulating hormone; COH, controlled oocyte hyperstimulation; Gn, gonadotropin; ICSI, intracytoplasmic sperm injection; IVF, \u003cem\u003ein vitro\u003c/em\u003e fertilization; DFP, dominant follicular proportions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05 indicates statistically significant differences.\u003c/p\u003e\n\u003cp\u003eTable S1 Marginal mean of DFP in the linear regression model of oocyte maturation rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDFP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003elow number of oocytes retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eBefore adjustment \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eAfter adjustment \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; DFP \u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e84.13 (83.42, 84.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e81.93 (81.17, 82.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; 30% \u0026le; DFP \u0026lt; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e84.19 (83.74, 84.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e82.14 (81.62, 82.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eDFP \u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e84.00 (83.10, 84.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e82.32 (81.37, 83.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.931\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.794\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e unadjusted marginal means (95% confidence intervals).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u0026nbsp;\u003c/sup\u003emarginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e Chi-square tests between pairwise comparisons based on marginal means.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable S2 Marginal mean of COH protocol in the linear regression model of oocyte maturation rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 34px;\"\u003e\n \u003cp\u003eCOH protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003eoocyte maturation rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eBefore adjustment \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eAfter adjustment \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eGnRH antagonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e84.60 (83.85, 85.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e82.12 (81.30, 82.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003elong GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e83.73 (83.09, 84.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e81.60 (80.87, 82.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003edepot GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e84.18 (83.68, 84.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e82.66 (82.07, 83.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e unadjusted marginal means (95% confidence intervals).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u0026nbsp;\u003c/sup\u003emarginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e Chi-square tests between pairwise comparisons based on marginal means.\u003c/p\u003e\n\u003cp\u003eLOMR was defined as an oocyte maturation rate below 40%. A binary logistic regression model was constructed to identify independent factors associated with LOMR (\u003cstrong\u003eTable 5\u003c/strong\u003e). Results indicated that DFP was not significantly associated with LOMR (\u003cem\u003eP\u003c/em\u003e\u0026gt;0.05). Compared with IVF, ICSI was associated with an increased risk of LOMR (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001). Interestingly, however, a higher number of oocytes retrieved (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), advanced maternal age (\u003cem\u003eP\u003c/em\u003e=0.024), and the use of depot GnRHa and long GnRHa protocols (\u003cem\u003eP\u003c/em\u003e=0.006) were associated with a reduced risk of LOMR. Similarly, after adjusting for confounders, the adjusted marginal means did not differ significantly across DFP groups (\u003cstrong\u003eTable S3\u003c/strong\u003e, \u003cem\u003eP\u003c/em\u003e\u0026gt;0.05), but did differ significantly among COH protocols (\u003cstrong\u003eTable S4\u003c/strong\u003e, \u003cem\u003eP\u003c/em\u003e=0.028).\u003c/p\u003e\n\u003cp\u003eTable 5. Binary logistic regression of COH protocol, DFP, and low oocyte maturation rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eInfertility type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; Primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.051\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.736-1.500\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.786\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eInfertility duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.044\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.980-1.112\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.186\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eFemale age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e0.949\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.906-0.993\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.024\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.055\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e1.000-1.114\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.052\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eBasal FSH level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.002\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.909-1.105\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.968\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eCOH protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; GnRH antagonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.324\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.886-1.979\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.172\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003elong GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e1.632\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e1.153-2.309\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e0.006\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; depot GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eln (Gn dosage per day)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e0.690\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.365-1.303\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.253\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eInsemination method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e3.351\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e2.462-4.561\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eDFP\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; DFP \u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.368\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.820-2.282\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.230\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; 30% \u0026le; DFP \u0026lt; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e1.121\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.701-1.794\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.633\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eDFP \u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eNo. of oocyte retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21px;\"\u003e\n \u003cp\u003e0.924\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\"\u003e\n \u003cp\u003e0.886-0.965\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: OR, odd ratio; REF, reference; CI, confidence interval; BMI, body mass index; FSH, follicle-stimulating hormone; COH, controlled oocyte hyperstimulation; Gn, gonadotropin; DFP, dominant follicular proportions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable S3 Marginal mean of DFP in the logistic regression model of low oocyte maturation rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDFP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003elow number of oocytes retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eBefore adjustment \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eAfter adjustment \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; DFP \u0026ge; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.024 (0.019, 0.031)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.027 (0.020, 0.036)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026nbsp; 30% \u0026le; DFP \u0026lt; 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.019 (0.016, 0.023)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.022 (0.018, 0.028)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eDFP \u0026lt; 30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.019 (0.013, 0.027)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.020 (0.013, 0.030)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e0.407\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e unadjusted marginal means (95% confidence intervals).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u0026nbsp;\u003c/sup\u003emarginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e Chi-square tests between pairwise comparisons based on marginal means.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable S4 Marginal mean of COH protocol in the logistic regression model of low oocyte maturation rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 34px;\"\u003e\n \u003cp\u003eCOH protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003elow number of oocytes retrieved\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eBefore adjustment \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eAfter adjustment \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eGnRH antagonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.023 (0.017, 0.030)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.023 (0.017, 0.033)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003elong GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.024 (0.019, 0.031)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.029 (0.022, 0.038)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003edepot GnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.016 (0.013, 0.021)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.018 (0.013, 0.023)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e unadjusted marginal means (95% confidence intervals).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u0026nbsp;\u003c/sup\u003emarginal means (95% confidence intervals) adjusted for infertility duration, female age, BMI, basal FSH, average Gn dosage, and number of retrieved oocytes.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e Chi-square tests between pairwise comparisons based on marginal means.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrincipal Findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this large retrospective cohort of 9,319 fresh IVF/ICSI cycles, dominant follicular proportion (DFP) on the day of hCG trigger was not significantly associated with oocyte maturation rate or the risk of low oocyte maturation rate across the three most commonly used controlled ovarian hyperstimulation (COH) protocols in China. The only exception was that in intracytoplasmic sperm injection (ICSI) cycles using the depot gonadotropin-releasing hormone agonist (GnRHa) protocol, a DFP \u0026ge;60% was associated with a significantly lower oocyte maturation rate. After adjustment for confounders, COH protocol type was significantly associated with oocyte maturation outcomes, whereas DFP group was not.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults in the Context of What is Known\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrevious studies have yielded heterogeneous results regarding the relationship between follicle size, delayed hCG trigger, and oocyte developmental competence \u003csup\u003e1,9,10,15\u003c/sup\u003e. Some investigations supported a positive correlation between follicular diameter and oocyte maturity or embryo quality\u003csup\u003e16,17,18,19\u003c/sup\u003e, leading to clinical practice of delaying trigger to obtain more large follicles. Conversely, other work demonstrated that prolonged stimulation or excessively high DFP may compromise oocyte quality and pregnancy outcomes\u003csup\u003e4,7,8,20,21\u003c/sup\u003e. Our findings are consistent with studies showing that increasing follicle size to elevate DFP does not enhance oocyte maturation and may even be harmful\u003csup\u003e7,20,21\u003c/sup\u003e. Most prior studies focused on a single COH protocol or included smaller samples\u003csup\u003e4,8\u003c/sup\u003e, whereas the present large‑scale comparison across three major regimens helps explain inconsistent conclusions in the literature\u003csup\u003e10,13\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Implications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePursuing excessively high DFP by delaying\u0026nbsp;hCG trigger does not improve oocyte maturation and may reduce oocyte quality in selected clinical scenarios. These findings challenge the conventional size‑centric criteria for trigger timing\u003csup\u003e1,2,7,15\u003c/sup\u003e and support individualized, protocol‑specific decision‑making. Earlier trigger may better safeguard oocyte quality across all three COH protocols. The depot GnRHa protocol was associated with more favorable oocyte maturation outcomes, consistent with prior evidence suggesting benefits of this regimen in normal responders\u003csup\u003e14\u003c/sup\u003e. Prospective randomized trials are required to confirm these observations before widespread clinical implementation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Implications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKey unanswered questions include the generalizability of these findings to older women, poor ovarian responders, and patients at risk of ovarian hyperstimulation syndrome. Future research should establish protocol‑specific DFP thresholds for trigger timing in randomized controlled designs. Long‑term studies evaluating cumulative live birth rates associated with different DFP strata are needed. Further investigation is also warranted to clarify how varying gonadotropin types and dosages modify the relationship between DFP and oocyte maturation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and Limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStrengths include the very large single‑center sample, strict inclusion criteria that balanced baseline characteristics across subgroups, and direct comparison of the three dominant COH protocols used in China\u003csup\u003e14\u003c/sup\u003e. Standardized outcome definitions and multivariable adjustment enhance the robustness of analyses.\u003c/p\u003e\n\u003cp\u003eLimitations include the retrospective design, which carries inherent risk of residual confounding. The study was restricted to young normal responders, limiting generalizability. Ultrasound measurement of follicular diameter is subjective, introducing potential variability in DFP assessment. Cumulative pregnancy outcomes were not available within the study timeframe, and variations in gonadotropin preparations and dosing may have influenced results.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, across the three predominant COH protocols, excessively postponing the\u0026nbsp;hCG trigger to pursue a greater number of larger follicles does not improve oocyte maturation rates. In certain clinical scenarios, earlier triggering may be considered to safeguard oocyte quality. These insights support a more nuanced, protocol-informed approach to trigger timing, moving beyond size-centric criteria toward individualized management.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics approval and consent to participate:\u003c/h2\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. All procedures were conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003enot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eStatement\u003c/strong\u003e: The authors declare no competing interests.\u003c/p\u003e\n\u003ch2\u003eFunding Statement:\u003c/h2\u003e\n\u003cp\u003eThis study was supported by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDC0200000), the Fertility Research Program of Young and Middle-aged Physicians in 2024 (No. BJHPA-2024-SHZHYXZHQNYJ-012), and the Hubei Province Health and Family Planning Scientific Research Project (WJ2023M117).\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eS.L. performed the investigation, conducted the statistical analysis, and drafted the manuscript. J.B. contributed to study conceptualization, acquired funding, and revised the manuscript. H.S. participated in manuscript drafting. L.J. contributed to project administration and data curation. Y.L. participated in the investigation and supervised the study. C.L. contributed to data curation. K.Q. contributed to study conceptualization, acquired funding, supervised the study, and critically revised the manuscript. All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe data analyzed in this study are subject to institutional restrictions and are therefore not publicly available. Requests for access can be directed to the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLin HY, Li Y, Wang WJ, Qiu Q, Zhang QX, Li Y. Role of the proportion of dominant follicles in patients with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer. Chinese Med journal Jun. 2019;20(12):1448\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMochtar MH, Custers IM, Koks CA, et al. Timing oocyte collection in GnRH agonists down-regulated IVF and ICSI cycles: a randomized clinical trial. Hum Reprod (Oxford England). May 2011;26(5):1091\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXie Q, Ni D, Chen S, et al. Meta-analysis of trigger timing in normal responders undergoing GnRH antagonist ovarian hyperstimulation protocol. Journal ovarian research Mar. 2024;5(1):56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSu H, Lai Y, Li J, et al. Increasing dominant follicular proportion negatively associated with good clinical outcomes in normal ovarian responders using the depot GnRH agonist protocol: a large-sample retrospective analysis. Journal ovarian research Apr. 2022;13(1):44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrvieto R. A simplified universal approach to COH protocol for IVF: ultrashort flare GnRH-agonist/GnRH-antagonist protocol with tailored mode and timing of final follicular maturation. Journal ovarian research Nov. 2015;4:8:69.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi Y, Li Y, Lai Q et al. Oct. 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Correlation between human follicular diameter and oocyte outcomes in an ICSI program. Journal Assist Reprod genetics Apr. 2003;20(4):143\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMehri S, Levi Setti PE, Greco K, Sakkas D, Martinez G, Patrizio P. Correlation between follicular diameters and flushing versus no flushing on oocyte maturity, fertilization rate and embryo quality. J Assist Reprod Genet. Jan 2014;31(1):73\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraga DP, Bonetti TC, da Silva ID, Setti AS, Iaconelli AJ, Borges EJ. The developmental competence of oocytes retrieved from the leading follicle in controlled ovarian stimulated cycles. International J fertility \u0026amp; sterility Jan. 2013;6(4):272\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen Y, Zhang Y, Hu M, Liu X, Qi H. Timing of human chorionic gonadotropin (hCG) hormone administration in IVF/ICSI protocols using GnRH agonist or antagonists: a systematic review and meta-analysis. Gynecological endocrinology: official J Int Soc Gynecol Endocrinology Jun. 2014;30(6):431\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNogueira D, Friedler S, Schachter M, Raziel A, Ron-El R, Smitz J. Oocyte maturity and preimplantation development in relation to follicle diameter in gonadotropin-releasing hormone agonist or antagonist treatments. Fertil Steril. Mar 2006;85(3):578\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"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":"journal-of-ovarian-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jovr","sideBox":"Learn more about [Journal of Ovarian Research](http://ovarianresearch.biomedcentral.com)","snPcode":"13048","submissionUrl":"https://submission.nature.com/new-submission/13048/3","title":"Journal of Ovarian Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"COH protocol, Follicle diameter, IVF/ICSI, Oocyte maturation rate, Trigger time","lastPublishedDoi":"10.21203/rs.3.rs-9398415/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9398415/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eOBJECTIVE\u003c/h2\u003e \u003cp\u003eTo clarify whether dominant follicular proportion (DFP) on hCG trigger day is associated with oocyte maturation rate and low oocyte maturation rate across three widely used controlled ovarian hyperstimulation (COH) protocols in China, and to provide evidence for individualized trigger timing.\u003c/p\u003e\u003ch2\u003eSTUDY DESIGN:\u003c/h2\u003e \u003cp\u003eA single-center, large-sample retrospective cohort study including 9,319 women undergoing their first fresh IVF or ICSI cycle between January 2021 and January 2024. Eligible participants were aged\u0026thinsp;\u0026le;\u0026thinsp;38 years with BMI\u0026thinsp;\u0026le;\u0026thinsp;30 kg/m\u0026sup2;, basal FSH\u0026thinsp;\u0026lt;\u0026thinsp;12 mIU/mL, and 6\u0026ndash;15 follicles\u0026thinsp;\u0026ge;\u0026thinsp;14 mm on trigger day. Cycles used depot GnRHa, long GnRHa, or GnRH antagonist protocols. Patients were stratified by DFP: \u0026lt;30%, 30%\u0026ndash;60%, \u0026ge;\u0026thinsp;60%. Outcomes included oocyte maturation rate and low maturation rate (\u0026lt;\u0026thinsp;40%). Multivariate linear regression and binary logistic regression were used for adjusted analyses, with P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 considered significant.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eBaseline characteristics were balanced across DFP subgroups within each protocol. Overall, DFP was not significantly associated with oocyte maturation rate across the three COH protocols (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Only depot GnRHa ICSI cycles showed significantly lower maturation in the DFP\u0026thinsp;\u0026ge;\u0026thinsp;60% group versus lower DFP groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). DFP was not associated with low oocyte maturation rate (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). ICSI was associated with higher risk of low maturation (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while greater oocyte yield, older age, and depot/long GnRHa protocols were associated with lower risk (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). COH protocol type significantly affected maturation outcomes (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eCONCLUSION\u003c/h2\u003e \u003cp\u003eExcessively delaying hCG trigger to increase DFP does not improve oocyte maturation across the three main COH protocols. Earlier trigger may better preserve oocyte quality. Trigger timing should be individualized and protocol-specific rather than relying solely on follicle size criteria.\u003c/p\u003e","manuscriptTitle":"Delayed hCG Trigger Does Not Improve Oocyte Maturation Rate: Evidence from 9,319 IVF/ICSI Cycles Using Three Controlled Ovarian Hyperstimulation Protocols","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-04 19:54:26","doi":"10.21203/rs.3.rs-9398415/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"342382738176240540014953163110278355","date":"2026-04-28T19:42:46+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-24T00:08:30+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-20T13:34:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-20T13:33:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Ovarian Research","date":"2026-04-13T03:52:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-ovarian-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jovr","sideBox":"Learn more about [Journal of Ovarian Research](http://ovarianresearch.biomedcentral.com)","snPcode":"13048","submissionUrl":"https://submission.nature.com/new-submission/13048/3","title":"Journal of Ovarian Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"113938d8-5a03-47bb-ba06-2c95bb168d39","owner":[],"postedDate":"May 4th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T19:54:26+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-04 19:54:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9398415","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9398415","identity":"rs-9398415","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}