小剂量长效GnRH-a黄体中期卵巢刺激方案的临床效果分析  

Comparison of clinical effects of different low-dose long-acting gonadotropin-releasing hormone agonist in long protocol of controlled ovarian stimulation

作　　者：周红[1] 张波[2] 冯贵雪[2] 周莉[2] 谭舒尹[2] 刘茵[2] 

机构地区：[1]广西壮族自治区妇幼保健院生殖中心,南宁530003 [2]广西壮族自治区妇幼保健院

出　　处：《中国计划生育学杂志》2010年第5期298-301,共4页Chinese Journal of Family Planning

基　　金：广西自然科学基金(桂科自0832183);广西卫生厅课题(Z2007012;Z2007013;重200947)

摘　　要：目的:探讨小剂量长效促性腺激素释放激素激动剂(GnRH-a)黄体中期控制性卵巢刺激方案临床效果及对体外受精-胚胎移植(IVF-ET)的影响。方法:回顾性分析行IVF-ET治疗的患者资料,按照黄体中期使用的GnRH-a剂量不同分为两组,1组GnRH-a用量为1.25mg(1/3支),共154周期;2组GnRH-a用量为0.94mg(1/4支),共100周期,比较临床效果和IVF-ET结局。结果:两组对象卵巢刺激的时间及用药量比较差异无统计学意义(P>0.05),启动日及人绒毛膜促性腺激素(hCG)日卵泡?素(FSH)、黄体生成素(LH)、雌激素(E2)、孕激素(P)等水平两组差异无统计学意义(P>0.05)。两组启动日未达降调节标准比率差异有统计学意义(3.25%与10.00%,P<0.05),hCG日LH>5.0U/L的比率差异有统计学意义(1.95%与9.00%,P<0.05)。两组卵巢过度刺激综合征发生率差异无统计学意义(3.90%与7.00%,P>0.05);获卵数、优质胚胎率两组差异无统计学意义(P>0.05),1组的正常受精率较2组高,差异有统计学意义(P<0.05),移植周期妊娠率差异无统计学意义(57.33%与46.88%,P>0.05);胚胎种植率、早期流产率两组差异均无统计学意义(P>0.05)。结论:1.25mg与0.94mg剂量GnRH-a在黄体中期控制性卵巢刺激方案中,可以得到几乎相同妊娠结局,对于卵巢正常反应的人群,1.25mg剂量的效果更好些。Objective：To explore the influence and clinical effects of the low-dose long-acting gonadotropin-releasing hormone agonist（GnRH-a）in the long protocol of controlled ovarian stimulation for in vitro fertilization and embryo transfer（IVF-ET）.Methods：The clinical data of IVF-ET treatment were analyzed.According to the doses of GnRH-a used at mid-luteal phase,the women were divided into two groups：group 1（1.25mg,a total of 154 cycles）and group 2（0.94mg,a total of 100 cycles）.The clinical effects of controlled ovarian stimulation and IVF-ET outcomes were compared.Results：The duration of controlled ovarian stimulation and the dosage of GnRH-a showed no statistically significant difference（P 0.05）;the concentrations of follicle-stimulating hormone,luteinizing hormone（LH）,estradiol and progesterone of the two groups on the start date and the day of human chorionic gonadotropin（hCG）administration showed no significant differences（P 0.05）.More women couldn＇t reach a significantly profound degree of down-regulation on the start date in group 2（3.25% vs 10.00%,P0.05）.There were more women with more than 5.0 U/L of LH concentration on the day of hCG administration in group 2（1.95% vs 9.00%,P0.05）.There were no significant differences in the incidence of ovarian hyperstimulation syndrome,the number of retrieved oocytes,the rate of high quality embryes,clinical pregnancy rate in ET cycles,embryo implantation rate,and early abortion rate between the two groups（P all 0.05）.The rate of normal fertilization was significantly higher in group 1（57.33% vs 46.88%,P0.05）.Conclusion：Almost the same pregnancy outcomes can be obtained when using 1.25mg and 0.94mg of GnRH-a in the controlled ovarian stimulation protocol at mid-luteal phase,and the former is better for women with normal reaction in their ovaries.

关 键 词：促性腺激素释放激素激动剂 降调节 体外受精-胚胎移植 控制性卵巢刺激 

分 类 号：R714.8[医药卫生—妇产科学]