微刺激促排卵在IVF/ICSI卵巢低反应患者中的应用  

Application of Mild-stimulation Ovulation in IVF/ISCI Patients with Poor Ovarian Response

作　　者：孙丽君[1] 董孝贞[1] 岳丽芳[1] 宋娜[1] 夏欢[1] 

机构地区：[1]郑州大学第三附属医院生殖中心,郑州450052

出　　处：《生殖与避孕》2013年第4期239-243,共5页Reproduction and Contraception

摘　　要：目的:探讨微刺激促排卵在IVF/ICSI卵巢低反应患者中的应用。方法:回顾性分析进行IVF/ICSI助孕的卵巢低反应患者共114个周期,根据用药情况分为3组:A组(来曲唑组,34个周期),B组(克罗米芬组,41个周期),C组(短方案组,39个周期)。比较3组患者的一般情况、Gn使用天数及总量、IVF相关指标及助孕结局。结果:①年龄、体质量指数(BMI)、不孕年限、基础内分泌水平组间比较均无统计学差异(P>0.05)。②A组Gn使用天数及总量、hCG注射日E2水平、优质胚胎率低于C组(P<0.05);hCG注射日LH水平、提前排卵率高于C组(P<0.05);平均获卵数、受精率、卵裂率、着床率、临床妊娠率A组与C组间比较均无统计学差异(P>0.05)。③B组Gn使用天数及总量、hCG注射日E2水平、平均获卵数、卵裂率均低于C组(P<0.05);hCG注射日LH水平高于C组(P<0.05);提前排卵率、受精率、优质胚胎率、着床率、临床妊娠率B组与C组间均无统计学差异(P>0.05)。④B组Gn使用天数及总量高于A组(P<0.05);其余相关指标组间比较均无统计学差异(P>0.05)。结论:微刺激方案可以获得与GnRH-a短方案相近的临床效果,同时降低Gn使用总量,减轻患者单周期治疗费用,是卵巢储备功能低下患者较理想的促排卵方案。Objective： To explore the application of mild-stimulate ovulation in in vitro fertilization and embryo transfer （IVF-ET） among patients with poor ovarian response. Methods： Retrospective analysis of IVF/ ICSI poor ovarian response patients with a total of 114 cycles was performed. According to the difference of the ovarian stimulation, patients were divided into 3 groups： group A （letrozole group, LE group, 34 cycles）, group B （clomiphene citrate group, CC group, 41 cycles）, group C （short protocol group, 39 cycles）. The general situation of the patients, Gn dosage and period, indicators associated with IVF lab and clinical outcomes in the 3 groups were compared. Results： 1） Age, body mass index （BMI）, infertility duration, the basis of endocrine were not statistically different （P〉0.05） in 3 groups. 2） Gn dosage and treatment period, E2 level on hCG injection day and excellent embryo rate in group A were lower than those in group C （P〈0.05）; LH level on hCG injection day and ahead ofovulation rate in group A were higher than those in group C （P〈0.05）; average number of oocyte retrieved, fertilization rate, cleavage rate, implantation rate, clinical pregnancy rate were not significantly different between the groups （P〉0.05）. 3） Gn dosage and treatment period, E2 level on hCG injection day, the average number of oocyte retrieved and cleavage rate in group B were lower than those in group C （P〈0.05）; LH level on hCG injection day in group B was higher than that in group C （P〈0.05）; ahead of ovulation rate, fertilization rate, the rate of excellent embryos, implantation rate, clinical pregnancy rate were not significantly different between the two groups （P〉0.05）. 4） Gn dosage and treatment period in group B were higher than those in group A （P〈0.05）; other indicators between group A and group B were not significantly different （P〉0.05）. Conclusion： The mild- stimulation ovulation protocol can be used to obtain similar clinic

关 键 词：体外受精-胚胎移植(IVF-ET) 微刺激 卵巢低反应 克罗米芬(CC) 来曲唑(LE) 

分 类 号：R714.8[医药卫生—妇产科学]