微刺激联合拮抗剂促排卵方案在卵巢低反应患者IVF中的应用  

Application of mini-stimulation protocol combined with ovulation induction protocol with antagonist in IVF for patients with low ovarian reaction

作　　者：孙丽君[1] 王兴玲[1] 李巍巍[1] 管一春[1] 娄华[1] 夏欢[1] 

机构地区：[1]郑州大学第三附属医院生殖中心,河南郑州450052

出　　处：《中国妇幼保健》2011年第28期4387-4389,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨微刺激联合拮抗剂促排卵方案在卵巢低反应患者体外受精-胚胎移植中的应用效果。方法:回顾性分析进行IVF/ICSI助孕、应用微刺激方案的卵巢低反应患者共35个周期。根据是否联合应用拮抗剂分为两组。A组:来曲唑加HMG联合拮抗剂组共20个周期;B组:来曲唑加HMG未用拮抗剂组共15个周期。比较两组的Gn用量、平均获卵数、提前排卵周期率、受精率、可利用胚胎率、优胚率、临床妊娠率等各项指标。结果:①两组患者的平均年龄、不孕年限、基础内分泌水平比较,差异无统计学意义(P>0.05)。②hCG注射日血清LH水平B组明显高于A组,差异有统计学意义(P<0.05);hCG注射日血清E2水平、内膜厚度A组明显高于B组,差异有统计学意义(P<0.05);hCG注射日血清P水平两组比较,差异无统计学意义(P>0.05)。③A组平均获卵数显著高于B组,差异有统计学意义(P<0.05)。④两组之间的Gn用量、用药时间、受精率、卵裂率、移植周期率、可利用胚胎率、优胚率比较,差异无统计学意义(P>0.05)。⑤A组临床妊娠率(36.4%)高于B组(25.0%),A组提前排卵率(10%)低于B组(40%)。结论:微刺激联合拮抗剂者的促排效果要优于未用拮抗剂者。Objective：To explore the application effect of mini-stimulation protocol combined with ovulation induction protocol with antagonist in in vitro fertilization and embryo transfer（IVF-ET） for patients with low ovarian reaction.Methods：35 cycles of the patients with low ovarian reaction who were treated with IVF/ICSI and mini-stimulation protocol were analyzed retrospectively,then they were divided into two groups according to combined with antagonist or not： group A（20 cycles treated with letrozole plus HMG combined with antagonist） and group B（15 cycles treated with letrozole plus HMG）.The indexes including the doses of Gn,the average numbers of retrieved oocytes,the advanced ovulation cycle rates,the fertilization rates,the numbers of embryos suitable for embryo transfer,good quality embryo rates and clinical pregnancy rates in the two groups were compared.Results：There was no significant difference in average age,the duration of infertility and basic endocrine level between the two groups（P0.05）.The serum luteinizing hormone（LH） level on the day of human chorionic gonadotropin（HCG） injection in group B was significantly higher than that in group A（P0.05）.The serum estradiol level and the thickness of endometrium on the day of HCG injection in group A were significantly higher than those in group B（P0.05）.There was no significant difference in serum progestogen level on the day of HCG injection between the two groups（P0.05）.The average number of retrieved oocytes in group A was significantly higher than that in group B（P0.05）.There was no significant difference in the dose of Gn,administration time,fertilization rate,cleavage rate,transplantation cycle rate,the rate of embryos suitable for embryo transfer and good quality embryo rate between the two groups（P0.05）.The clinical pregnancy rate in group A was 36.4%,which was significantly higher than that in group B（25.0%）,the advanced ovulation rate in group A was 10%,which was significantly lower than that in

关 键 词：微刺激 拮抗剂 卵巢低反应 体外受精-胚胎移植 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]