超长方案在卵巢储备良好前次IVF/ICSI-ET失败患者中的应用分析  

Clinical outcomes of prolonged gonadotropin-releasing hormone agonist(GnRH-a) therapy used in patients with good ovarian reserves and previous in vitro fertilization or intracytoplasmic sperm injection embryo transfer(IVF/ICSI-ET) failure cycle.

作　　者：聂玲[1] 伍琼芳[2] 张寅[1] 陈晶晶[2] 

机构地区：[1]南昌大学医学院,南昌330006 [2]江西省妇幼保健院生殖中心

出　　处：《现代妇产科进展》2011年第6期470-472,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:评估超长降调节方案在卵巢储备良好前次IVF/ICSI-ET失败患者中的应用效果。方法:回顾分析246例卵巢储备功能良好前次IVF/ICSI-ET常规长方案失败再次行助孕治疗的患者,其中超长方案治疗52例为研究组,常规长方案治疗194例为对照组。结果:研究组Gn时间及获卵数均高于对照组(P<0.01);但优质胚胎数、Gn量、注射HCG日孕酮水平、移植日子宫内膜厚度、中-重度OHSS发生率与对照组比较均无明显统计学差异(P>0.05);研究组HCG阳性率、临床妊娠率均明显高于对照组,分别是:79.1%vs 61.1%,P=0.03;69.8%vs 54.9%,P=0.048,胚胎种植率有上升趋势(39.5%vs 31.5%,P=0.18)。结论:在前次卵巢反应良好IVF/ICSI-ET失败患者中超长方案较长方案子宫内膜容受性可能更好,妊娠结局明显改善,是值得推荐的治疗方案。Objective：To evaluate the clinical outcomes of prolonged gonadotropin-releasing hormone agonist therapy（GnRH-a） used in patients with good ovarian reserves and previous in vitro fertilization or intracytoplasmic sperm injection embryo transfer（IVF/ICSI-ET） failure cycle.Methods：Retrospective analyze a total of 246 patients with previous IVF-ET failure cycle and good ovarian reserve who underwent the secondary IVF-ET cycles.Patients were divided into two groups：the study group included 52 patients applied with prolonged protocol;the control group included 194 patients applied with long protocol.Results：The number of oocytes retrieved and the duration of gonadotropin（Gn） were significantly higher in the study group（P0.01）.But there were no significant differences in the dose of Gn,total number of good quality embryos,mean endometrium thickness on transfer day,mean serum P level on human chorionic gonadotrophin（HCG） day and severe ovarian hyperstimulation syndrome（OHSS） rate between the two groups（P 0.05）.The positive HCG rate and clinical pregnancy rate（CPR） increased obviously in the study group,respectively（79.1% vs 61.1%,P=0.03;69.8% vs 54.9%,P=0.048）.And there was an increasing tendency in implantation rate（39.5% vs 31.5%,P=0.18）.Conclusion：Using prolonged gonadotropin-releasing hormone agonist therapy in patients with good ovarian reserves and previous IVF-ET failure cycle may make the endometrium receptivity better than using the long protocol,and improve obviously the clinical pregnancy outcomes.So the prolonged protocol is recommendable.

关 键 词：超长方案 体外受精-胚胎移植 促性腺激素释放激素激动剂 子宫内膜容受性 胚胎种植率 临床妊娠率 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]