超排卵中卵泡发育不均匀不同处理方法的临床观察  

Clinical observation on the different treatment methods for follicle heterogeneity during controlled ovarian hyperstimulation

作　　者：李豫峰[1] 方春霞[1] 章汉旺[1] 朱桂金[1] 靳镭[1] 艾继辉[1] 赖巧红[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中心,湖北武汉430030

出　　处：《中国妇幼保健》2011年第28期4390-4393,共4页Maternal and Child Health Care of China

摘　　要：目的:研究长方案超排卵中卵泡发育不均匀两种不同处理方法及其临床结局。方法:回顾性分析IVF/ICSI超排卵中出现优势卵泡的251例患者,按不同处理方法分为三组:A组(穿刺优势卵泡组)103例,B组(加大GnRH-a剂量组)92例,C组(对照组)56例。比较三组获卵数、可利用胚胎数、妊娠率、活产率等指标。结果:A组获卵数和成熟卵数高于C组(P<0.05);A组和B组成熟卵比率、受精率、可用胚胎数均显著高于C组(P<0.05),妊娠率、活产率和累计妊娠率、累计活产率高于C组,但无统计学差异。而A组与B组相比,优势卵泡与次级大卵泡的直径差异大,Gn天数长,GnRH-a用量小,但临床结局相似。结论:处理卵泡发育不均匀,优势卵泡穿刺和加大GnRH-a剂量治疗均有效,当主导卵泡和次级大卵泡的直径差异相对较小时,采用加大GnRH-a剂量较合理;而差异较大时,采用优势卵泡穿刺术更佳。Objective：To study two kinds of methods to treat follicle heterogeneity during controlled ovarian hyperstimulation and the clinical outcomes.Methods：251 cases with dominant ovarian follicle during in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） hyperstimulation were analyzed retrospectively,then they were divided into three groups according to different treatment methods： group A（puncture of dominant ovarian follicle,103 cases）,group B（high dose of GnRH-a,92 cases） and group C（control group,56 cases）.The indexes including the numbers of retrieved oocytes,the numbers of embryos suitable for embryo transfer,the pregnancy rates and live birth rates in the three groups were compared.Results：The number of oocytes retrieved and the number of mature oocytes in group A were significantly higher than those in group C（P0.05）;the proportions of mature oocytes,fertilization rates and the numbers of embryos suitable for embryo transfer in group A and group B were significantly higher than those in group C（P0.05）;the pregnancy rates,living birth rates,cumulative clinical pregnancy rates and cumulative living birth rates in group A and group B were higher than those in group C,but there was no significant difference.Compared with group B,the difference of diameter between dominant ovarian follicle and secondary follicle in group A was bigger,the time of gonadotropin usage was longer,the dose of GnRH-a was lower,but the clinical outcomes in group A and group B was similar.Conclusion：Puncture of dominant ovarian follicle and GnRH-a treatment of high dose both are effective in treatment of follicle heterogeneity,when the difference of diameter between dominant ovarian follicle and secondary follicle is small,it is reasonable to adopt GnRH-a treatment of high dose;when the difference of diameter between dominant ovarian follicle and secondary follicle is large,puncture of dominant ovarian follicle is preferred.

关 键 词：控制性超排卵 卵泡发育不均匀 卵泡穿刺 GNRH-A 

分 类 号：R714.13[医药卫生—妇产科学]