提早加用促性腺激素释放激素拮抗剂可改善低反应患者的助孕效果  

Early initiation of GnRH antagonist can improve IVF efficiency in poor responders

作　　者：罗克莉[1] 郭慧[1] 龚斐[1] 

机构地区：[1]中南大学湘雅医学院生殖与干细胞研究所,中信湘雅生殖与遗传专科医院生殖中心,长沙市410078

出　　处：《实用医学杂志》2012年第13期2211-2213,共3页The Journal of Practical Medicine

摘　　要：目的:探讨体外受精-胚胎移植(IVF-ET)/卵细胞浆内单精子注射周期中低反应患者提早加用促性腺激素释放激素(GnRH)拮抗剂对助孕效果的影响。方法:回顾性分析卵泡达14mm(198个周期,A组)和12mm(269个周期,B组)开始用GnRH拮抗剂的两组患者,比较其促性腺激素(Gn)使用天数和剂量、GnRH拮抗剂所用天数、HCG日血清雌二醇、黄体生成素、孕酮水平、获卵数、着床率(IR)、临床妊娠率(PR)等。结果:B组Gn使用天数短,但Gn总量增加,早发LH峰有降低的趋势,B组IR、PR和远期妊娠率均显著高于A组。结论:提早至卵泡达12mm即加用GnRH拮抗剂可改善IVF-ET助孕效果。Objective To investigate the efficiency of in vitro fertilization and embryo transfer （IVF-ET） in low responders when GnRH antagonist was initiated with the leading follicle of different size. Methods Retrospective study was performed with 467 cycles. Antagonist was initiated when the leading follicle reached 14 mm in group A with 198 cycles, and antagonist was initiated when the leading follicle reached 12 mm in group B with 269 cycles. The Gn duration and dosage, antagonist duration, estradiol （E2）, luteinizing hormone （LH）, progesterone （P） on HCG day, number of oocytes retrieved,implantation rate （IR） and clinical pregnancy rate （PR） were compared in both two groups. Results Gn duration was decreased, but the total dosage increased in group B. The occurrence of premature LH peak tended to decrease, the implantation rate and clinical pregnancy rate in group B were significantly higher than those in group A. Conclusion An early initiation of antagonist contributes to an improved IVF outcome when the leading follicle reaches 12 mm.

关 键 词：受精 体外 胚胎移植 促性腺激素释放激素拮抗剂 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]