口服避孕药用量对超促排卵的影响  

Effect of oral contraceptive pills dose on controlled ovarian hyperstimulation

作　　者：李豫峰[1] 王玲[1] 熊露[1] 赖巧红[1] 饶群[1] 章汉旺[1] 刘玉芹[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院生殖医学中心,湖北武汉430030

出　　处：《中国妇幼保健》2011年第4期551-553,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨超促排卵长方案中,采用口服避孕药联合促性腺激素释放激素激动剂双降调在体外受精-胚胎移植中的应用价值。方法:共收集397例月经规律患者行体外受精-胚胎移植,均采用长方案超促排卵,降调节均为达菲林0.1 mg隔日皮下注射共7支;其中未服用妈富隆组25例(Ⅰ组),于月经第19天直接降调;常规服用妈富隆组194例(Ⅱ组),于月经第3天起服用妈富隆,1次/日,共21片,于月经第19天降调;加用剂量组(Ⅲ组)178例于月经第3天起服用妈富隆,1次/日,服用22～63片,其中服用2个周期(42片)及3个周期(63片)有9例,于月经第19～21天降调。结果:降调后E2、LH水平用药组较未用药组低,LH水平加大剂量组较常规用药组激素水平更低;而优势卵泡数未用药组较加大剂量组高;降调天数、获卵数、GN用量、HCG日内膜厚度、可用胚胎数、妊娠率、受精率、OHSS发生率无统计学差异。结论:①在体外受精-胚胎移植长方案中,对于月经规律患者应用口服避孕药可以更有效抑制激素水平,达到充分降调节,不影响内膜厚度、获卵数、妊娠率等,建议应用口服避孕药;②口服避孕药用量越大,降调后激素水平越低,优势卵泡数减少,建议应用1个周期的口服避孕药,不推荐口服避孕药长时间应用。Objective：To explore the application value of oral contraceptive pills（OCPs） combined with gonadotrophin releasing hormone agonist（GnRH-a） in dual suppression of in vitro fertilization-embryo transplantation（IVF-ET） in long protocol of controlled ovarian hyperstimulation.Methods：397 cases with regular menstruation received IVF-ET（long protocol of controlled ovarian hyperstimulation）,0.1 mg Diphereline was injected subcutaneously every two days for 7 times;25 cases did not take Marvelon（group Ⅰ）,down-regulation was performed on the nineteenth day of menstruation;194 cases took Marvelon conventionally（group Ⅱ） from the third day of menstruation,once a day for 21 pills,then down-regulation was performed on the nineteenth day of menstruation;178 cases took large dose Marvelon（group Ⅲ） from the third day of menstruation,once a day for 22～63 pills,9 cases took large dose Marvelon for two cycles（42 pills） and three cycles（63 pills）,down-regulation was performed on the 19th～21st day.Results：After down-regulation,the levels of E2 and LH in medication group were significantly lower than those in non-medication group,the levels of hormones in group Ⅲ were significantly lower than those in group Ⅱ;the number of dominant follicles in group Ⅰ was larger than that in group Ⅲ;there was no significant difference in days of down-regulation,the number of retrieved oocytes,the dose of GnRH-a,the endometrial thickness on HCG day,the number of available embryos,the pregnancy rate,the fertilization rate and the incidence of OHSS among the three groups.Conclusion：In long protocol of IVF-ET,oral contraceptive pills can be used for cases with regular menstruation in order to suppress the levels of hormones effectively and achieve sufficient down-regulation,which do not affect the endometrial thickness,the number of retrieved oocytes and the pregnancy rate;after down-regulation,the level of hormones and the number of dominant follicles decreases with the increase of oral contrac

关 键 词：体外受精-胚胎移植 超促排卵 降调节 口服避孕药 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]