来曲唑微刺激促排卵在卵巢储备下降患者IVF-ET中的应用  

Mild ovarian stimulation with letrozole for in vitro fertilization and embryo transfer in diminished ovarian reserve patients

作　　者：江成龙[1] 郑蓉[2] 罗丽娟[1] 周晓艳[1] 梁慧子[1] 黄晓卉[1] 张昌军[1] 

机构地区：[1]湖北医药学院附属人民医院生殖医学中心,十堰442000 [2]湖北医药学院附属太和医院妇产科,十堰442000

出　　处：《中国优生与遗传杂志》2012年第10期116-117,102,共3页Chinese Journal of Birth Health & Heredity

基　　金：湖北省教育厅科研项目(B20092411)

摘　　要：目的研究来曲唑微刺激促排卵应用于卵巢储备降低患者行IVF-ET的效果。方法 346名拟行IVF-ET的卵巢储备降低的不孕患者随机分成来曲唑微刺激促排卵组(A组n=226)和GnRH-a短方案组(B组n=120),比较两组促排卵天数,Gn总量,获卵数,优胚率、临床妊娠率,多胎率和流产率。结果来曲唑促排组促排天数、Gn总量、诱导日E2、获卵数、受精率、可利用胚胎数、种植率、临床妊娠率显著低于短方案组(P<0.05),诱导日LH、P水平高于Gn-RHa短方案组(P<0.05),而两组的诱导日内膜厚度、卵裂率、优质胚胎率、移植胚胎数、多胎率、流产率差异均无显著统计学意义(P>0.05)。结论对于卵巢储备降低的患者行IVF-ET助孕时来曲唑微刺激促排卵可以减少Gn用量,但是在妊娠率上并不优于GnRH-a短方案。Objective： To discuss the effect of mild ovarian stimulation with letrozole for diminished ovarian reserve patients.Methods： A total of 346 ovarian stimulation cycles were included,among them 226 cycles received mild ovarian stimulation with letrozole（group A）,and 120 cycles received GnRH-a short protocol（group B）.The total gonadotrophin consumption,total stimulation duration and clinical outcomes were compared between the two groups.Results： The total stimulation duration,the total gonadotrophin consumption,The serum E2 on the day of hCG administration,oocytes retreaved,fertilization rate,number of embryo utilizable,implantation rate and pregnancy rate were significantly higher in group B than that in group A.Serum LH and P on day of hCG administration of group A was significantly higher than that of group B（P〈0.05）,There were no significant differences between the two groups in endometrial thickness on the day of hCG administration,cleavage rate,good embryo rate,number of embryo transferred,multipregnancy rate and abortion rate（P〈0.05）.Conclusion： Comparing with the mild ovarian stimulation with letrozole,the GnRH-a short protocol is suitable for diminished ovarian reserve patients on pregnancy but for the gonadotrophin consumption.

关 键 词：来曲唑 微刺激促排卵 卵巢储备降低 短方案 

分 类 号：R714.8[医药卫生—妇产科学]