IVF周期中克罗米芬促排卵的临床效益分析  

A study of clinic efficiency on the strategy of superovulation based on clomiphene citrate in IVF

作　　者：孙迎利[1] 张敏[2] 张建平[2] 常秀峰[2] 朱爱萍[2] 马晓伟[2] 余裕炉[1] 

机构地区：[1]厦门大学附属第一医院生殖医学中心,厦门361003 [2]白求恩国际和平医院生殖医学中心,石家庄050082

出　　处：《中国优生与遗传杂志》2011年第8期102-105,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探索在玻璃化冷冻技术基础上IVF周期中克罗米芬促排卵方案的临床效果及经济效益分析。方法 2006年度101个病例在知情同意下随机分为两组,CC组为国产克罗米芬、HMG并辅以GnRH拮抗剂预防LH峰的促排卵方案;GnRHa组为以常规的GnRHa降调和果纳芬、辅以少量国产HMG的促排卵方案为主;所获胚胎根据子宫内膜条件实施鲜胚移植或玻璃化冷冻复苏后移植,每个病例追踪到孩子出生或所有胚胎用完或本人放弃为止;分析两组得卵数、受精率、2PN率、卵裂率、优良胚胎率、取卵周期活婴分娩率、促排卵药费、周期平均总费用以及每获得一次活婴分娩的平均费用等参数。结果 CC和GnRHa组平均得卵数分别为7.46±4.04和10.19±3.95枚,有极显著性差异;IVF/ICSI受精率分别为85.1%/88.3%和68.3%/76.0%,有极显著性差异;促排卵药费、周期平均总费用以及每获得一次活婴分娩的平均费用分别为1779.65±1123.59元、11008.81±2987.36元、27447.67±7164.10元和9241.62±2883.20元、19393.87±3297.55元、48946.43±8322.38元,组间有极显著性差异,差异因素来源于促排卵药费;2PN率、卵裂率、优良胚胎率、冻胚移植胚胎植入率、取卵周期活婴分娩率分别为84%、97.4%、85.4%、29.1%、37.5%和79%、96.5%、83.3%、34.7%、39.6%,两组间无显著性差异;两组均无熟前LH峰和严重并发症发生事件。结论 IVF中使用克罗米芬联合HMG和GnRH拮抗剂促排卵,结合胚胎玻璃化冷冻技术是一种安全、高效和经济的治疗策略。Objective：To explore the efficiency on clinic for a ovarian hyperstimulation strategy based on clomiphene citrate（CC） and embryos vitrified cryopreservation technique in IVF.Methods：101 of IVF cycles,duration of 2006 annum,were randomly divided into CC and GnRHa groups,after in written form consent.For the group CC,ovarian hyperstimulation was done using CC,from the second day of the bleeding,at least duration of 8 days or until on the day of HCG injection,in a fixed dosage of 150 mg per day,supplemented with vary dosages of HMG on whole period of follicular phase,and short life GnRH antagonist（Cetrotide,Serono） on late follicular phase,according to different persons individually;For the group GnRHa,a pituitary down-regulation was done,using GnRHa（Dophereline,Beaufouripsen） and then vary dosages of recombinant FSH（Gonal-F,Serono） were injected individually,as commonly used like elsewhere.A proper number of resulting embryos were transferred into uterus under supervision of an abdomen ultrasound,or all of them was cryopreserved until a proper condition was met,according to the state of their endometrium.Average numbers of ovum picked up,2PN rates,cleavage rates,rates of grade1-2 embryos,fee on medicine for ovarian hyperstimulation,total fee per cycle,live birth rates and average fee for successfully gain a live birth cycle were statistically analyzed.Results：2PN rates,cleavage rates,rates of grade1-2 embryos,implantation rates for FET and take-home baby rates were 84%,97.4%,85.4%,29.1%,37.5% and 79%,96.5%,83.3%,34.7%,39.6%,respectively in CC and GnRHa groups,with no significant differences,and meanwhile,average numbers of ovum picked up,fertilization rates of IVF/ICSI,fee on medicine for ovarian hyperstimulation,total fee per cycle,take-home baby rates and average fee for successfully gain a live birth cycle were 7.46±4.04,85.1%/88.3%,1779.65±1123.59 Yuans,11008.81±2987.36 Yuans,27447.67±7164.1 Yuans and 10.19±3.95,68.3%/76.0%,9241.62±2883.20 Yuans,19393.87±3297.55 Yuans,48946.43±8322

关 键 词：体外授精 克罗米芬 控制性促排卵 玻璃化冷冻 

分 类 号：R711.75[医药卫生—妇产科学]