Transfer strategies for POR patients undergoing antagonist protocol in assisted&nbsp; pregnancy

doi:10.13418/j.issn.1001-165x.2026.3.12

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Chinese Journal of Clinical Anatomy ›› 2026, Vol. 44 ›› Issue (3) : 323-328. DOI: 10.13418/j.issn.1001-165x.2026.3.12

Transfer strategies for POR patients undergoing antagonist protocol in assisted pregnancy

Liu Yan, Li Tao, Gao Jing, Sun Li*

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Abstract

Objective To explore the optimal embryo transfer strategy for poor ovarian response (POR) patients with embryos of different quality. Methods A retrospective analysis was performed on 411 POR patients (≤3 oocytes retrieved) treated with the antagonist protocol and IVF/ICSI at the Reproductive Center of the Third Affiliated Hospital of Sun Yat-sen University from January 2018 to May 2024. Cycles were divided into fresh transfer (Group A, n=234) and frozen transfer (Group B, n=177), all with Day 3 cleavage-stage embryo transfer. Subgroups were categorized by embryo quality: good-quality embryos (A1=95, B1=50), good plus fair/poor-quality embryos (A2=54, B2=74), and fair/poor-quality embryos only (A3=85, B3=53). Baseline characteristics and clinical outcomes (pregnancy rate, implantation rate, live birth rate, miscarriage rate) were compared. Results The patients in transferring good-quality embryos or good plus fair/poor-quality embryos groups, there were no significant differences in clinical pregnancy, implantation, live birth or miscarriage rates between fresh and frozen cycles. The patients in fair/poor-quality embryos group, the clinical pregnancy rate in the frozen transfer group was significantly higher than that of the fresh transfer group (30.19% vs. 14.12%, P=0.022) and the implantation rate was also higher than that of the fresh transfer group (22.33% vs. 10.62%, P=0.009), with no significant differences in live birth or miscarriage rates (P>0.05). Multivariate logistic regression showed that transfer mode (fresh vs. frozen) was not an independent factor affecting clinical pregnancy. Conclusions For POR patients (≤3 oocytes retrieved) under the antagonist protocol, fresh and frozen transfer show comparable outcomes when good-quality embryos are available. Frozen transfer is associated with higher clinical pregnancy and implantation rates when only fair/poor-quality embryos are transferred. These findings require verification in larger-sample studies.

Key words

Antagonist protocol / / / Poor ovarian response (POR) / / / Number of oocytes retrieved / Pregnancy rate / / / Live birth rate

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Liu Yan, Li Tao, Gao Jing, Sun Li. Transfer strategies for POR patients undergoing antagonist protocol in assisted pregnancy[J]. Chinese Journal of Clinical Anatomy. 2026, 44(3): 323-328 https://doi.org/10.13418/j.issn.1001-165x.2026.3.12

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