66例小剂量GnRHa用于IVF-ET术卵巢反应不良患者的临床研究  

The clinical study of low-dose of GnRHa for 66 cases of poor responder patients in IVF-ET cycles

作　　者：胡毅娜[1] 赵琰[1] 何锦霞[1] 

机构地区：[1]江西省妇幼保健院辅助生殖中心,南昌330006

出　　处：《中国优生与遗传杂志》2012年第2期101-102,106,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的在IVF-ET术中,针对卵巢反应欠佳的患者,采用小剂量GnRHa进行降调节,探讨其临床效果。方法所有患者66例均于使用Gn的前次月经周期优势卵泡排卵后肌肉注射长效GnRHa 0.34mg,达到降调节标准后,开始每日皮下注射短效GnRHa 0.05mg,同时肌肉注射rFSH或HMG,丽珠公司生产,常规取卵及移植。对Gn用量、Gn天数、获卵率、受精率、优质胚胎率及妊娠情况进行观察和统计分析。结果行IVF/ICSI的66例不孕病例共66个治疗周期中,无一出现内源性LH峰,获得较好的临床妊娠率,且所有患者均未出现卵巢过度刺激综合征等其它并发症。结论小剂量的GnRHa方案既可以在黄体晚期募集到质量较高的卵子,又可以在适量的垂体分泌的LH作用下促进卵泡发育和成熟,同时可以防止LH峰提前出现。因此今后临床对于年龄较大和卵巢反应不良的病人考虑使用小剂量的GnRHa进行降调节可能会有较好的治疗效果。Objective ： In IVF - ET cycles, we found some patients with poor ovarian response, in this part of the patients we have adopted a low - dose GnRHa to downregulation in order to explore its clinical effects. Methods ： All 66 patients before the controlled o- varian stimulation cycle received long - acting GnRHa 0. 34mg after ovulation. When achieved down - regulation standards, began a daily subcutaneous injection of short - acting GnRHa 0. 05mg, while intramuscular injection of rFSH or HMG, then all patients received conventional IVF - ET. Results： In these 66 protocols, all patients without an endogenous LH peak appeared, were not in ovarian hyperstimulation syndrome and other complications and catch a good clinical pregnancy rate. Conclusion ： Low - doses of GnRHa programs are able to recruit excellent - quality eggs in the late luteal, and the appropriate amount of pituitary LI-I secretion promote the follicular development and maturation, while prevent the LH peak occurred. Therefore, for the older patients and poor responders, we can use low - doses of GnRHa down - regulation. It may be a better therapeutic effect.

关 键 词：体外受精-胚胎移植 小剂量GnRHa 卵巢反应不良 

分 类 号：R714.8[医药卫生—妇产科学]