3种方法治疗控制超排卵中卵巢低反应的疗效分析  

Applications of 3 kinds of methods to poor response in controlled ovarian hyperstimulation treatment

作　　者：黎平[1] 郭江华[1] 阮晓红[1] 陈晓燕[1] 邓爱民[1] 

机构地区：[1]广东省江门市中心医院生殖医学中心,广东江门529070

出　　处：《中国现代医学杂志》2007年第11期1367-1370,1373,共5页China Journal of Modern Medicine

摘　　要：目的探讨治疗控制超排卵中卵巢低反应的有效、经济、安全的方法。方法选择22例曾在体外受精治疗过程中使用常规长方案超排卵而发生卵巢低反应的患者,观察、治疗36个周期,将该36个周期随机分成3组:A组:于月经周期第3天起皮下注射达必佳0.1mg/d,连用3～5d,同时注射果纳芬300u/d,3～5d后根据卵泡生长情况决定是否继续使用果纳芬及决定果纳芬剂量,果纳芬最高剂量450u/d;B组:于月经第3～7d予来曲唑2.5mg/d;C组:于月经第3～7天予克罗米芬50mg/d。B、C组均于月经周期第8天后根据卵泡生长情况决定是否加用果纳芬75u/d及调整果纳芬剂量,果纳芬最高剂量225u/d。C组并根据子宫内膜生长情况决定是否加用补佳乐。3组患者均于1～3个优势卵泡平均直径≥18mm时,停止使用果纳芬,肌注绒毛膜促性腺激素10000u,36h后取卵,体外培养6h内体外受精或卵母细胞胞浆内单精子显微注射,72h后行胚胎移植。移植前行胚胎质量评分。胚胎移植后14d行尿妊娠试验判定是否生化妊娠;胚胎移植后28d作阴道B超判定是否临床妊娠。结果3组治疗后取消周期率、平均获卵数、平均受精率、平均优质胚胎发生率和妊娠率等差异无显著性;平均促性腺激素(Gn)用量A组最高,B、C组差异无显著性;平均获卵数A、C组差异无显著性,稍高于B组。结论对卵巢低反应患者,盲目增加Gn用量,并不能达到获得足够卵子的目的,选择少量、廉价、有效的促排卵药物,保证该类患者有限的卵泡顺利生长,可能会是更好的选择。[Objective] To find an economic, effective and secure method to the poor response in the treatment of controlled ovarian hyperstimulation. [Methods] 22 patients with poor response were treated for 36 cycles, which are divided into three groups randomly. The changes of related indexes were evaluated. [Resilts] The difference of cancelled cycle rate, the mean amount of retrieval ova, the mean fertilization rate, the high-quality embryos rate and the pregnancy rate were not significant among the there groups after treatment. The dose of Gn was the highest in group A and there was no statistical significance between group Band group C. The mean amount of retrieval ova in group A and C has no statistical significance, which was a little higher in group B. [ Conclusion] Simply increasing the does of Gn can＇t gain enough oocytes to the patients with poor response. Induction of ovulation with mini-dose, economical and effective medicine may be more beneficial to patients.

关 键 词：卵巢低反应 控制超排卵 体外受精-胚胎移植 

分 类 号：R715[医药卫生—妇产科学]