口服避孕药对促性腺激素释放激素激动剂短方案体外受精胚胎移植结局的影响  

Effect of oral contraceptive pills upon IVF outcomes of patients under a short GnRH agonist protocol

作　　者：田莉[1] 吴丹[1] 沈浣[1] 魏丽惠[2] 

机构地区：[1]北京大学人民医院生殖医学中心,100044 [2]北京大学人民医院妇科,100044

出　　处：《中华医学杂志》2010年第7期454-457,共4页National Medical Journal of China

基　　金：北京大学医学部“985工程”二期学科建设资助（985-2-015-24）

摘　　要：目的探讨促性腺激素释放激素激动剂（GnRH-a）短方案超排卵前，使用口服避孕药预治疗对体外受精胚胎移植（IVF—ET）妊娠的影响。方法分析186个GnRH—a短方案IVF-ET周期治疗情况。83个周期在短方案超排卵前口服避孕药1个周期（OCP组），103个启动超排卵前未使用过任何药物（非OCP组）。结果OCP组患者卵泡成熟日的子宫内膜厚度低于非OCP组（8．7mm比9．5mm P〈0．05），周期取消率高于非OCP组（24．1％比12．6％，P〈0．05）。OCP组的胚胎种植率、持续妊娠率均低于非OCP组，分别为（11．2％比19．9％，P〈0．05）（12．7％比27．8％，P〈0．05）。结论GnRH-a短方案超排卵前OCP的使用降低了IVF患者的胚胎种植率和持续妊娠率。Objective To determine the link between oral contraceptive pill （OCP） use and IVF/ ICSI treatment outcomes under a short GnRH agonist protocol. Methods A total of 186 patients （one cycle each patient） received a short GnRH agonist protocol at Day 2 of menstrual cycle for IVF/ICSI. Among them, 83 patients took OCP pre-treatment prior to the stimulation protocol （OCP group） and 103 patients received no OCP （ non-OCP group）. The triggering of final oocyte maturation was performed with 10 000 IU of hCG. Results The ongoing pregnancy rates per started cycle in the non-OCP group and OCP group were 27.8% and 12.7% （P 〈 0. 05 ） respectively. The clinical pregnancy rate and embryo implantation rate were significantly reduced in OCP group （clinicaJ pregnancy rate 16.5% , implantation rate 11.2% ） as compared with non-OCP group （32. 2% and 19. 9% , P 〈0. 05）. The endometrium on hCG day was thicker in non- OCP group than OCP group （ 9. 5 mm vs 8.7 mm, P 〈 0. 05 ）. Conclusion Pretreatment with OCP, as compared with initiation of stimulation at Day 2 of cycle in patients treated with GnRH-a short protocol antagonist appears to be associated with a significant difference in ongoing pregnancy rates per started cycle.

关 键 词：口服避孕药 GNRH 超排卵 体外受精 

分 类 号：R714.8[医药卫生—妇产科学]