低剂量长效促性腺激素释放激素激动剂在体外受精-胚胎移植中的应用  

Clinical application of low-dose of long-acting Gonadotropin-release hormone agonist (GnRH-a) in vitro fertilization-embryo transfer

作　　者：陈雅[1] 赵军招[1] 林金菊[1] 杨海燕[1] 陈霞[1] 

机构地区：[1]温州医学院附属第一医院生殖中心

出　　处：《中国临床药理学与治疗学》2013年第4期416-420,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨体外受精-胚胎移植(IVF-ET)中长效促性腺激素释放激素激动剂(GnRH-a)降调节的最低有效剂量。方法:回顾性分析2009年至2010年行体外受精(IVF)/单精子卵胞浆内注射(ICSI)治疗的长方案周期,根据黄体中期注射GnRH-a剂量分<0.6mg(A组),≥0.6mg<0.8mg(B组),≥0.8mg(C组),每组随机抽取100个周期,比较治疗效果。结果:三组的移植周期数分别为92个,80个及85个。三组成熟率、受精率、优质胚胎率、自然流产率及宫外孕率差异均无统计学意义(P>0.05)。A组种植率(37.91%)及每移植周期妊娠率(63.04%)均明显高于B组(25.14%及37.5%)和C组(23.16%及41.18%)(P<0.01),B组和C组相比差异无统计学意义(P>0.05)。C组Gn用量显著高于A组和B组(P<0.01),而启动日LH值及hCG日LH值均明显低于A组和B组(P<0.05)。结论:使用极低剂量GnRH-a能获得很好的临床结局。AIM： To investigate the subopti- mal dose of long-acting GnRH-a used for in vitro fertilization （IVF） or intraeytoplasmic sperm in- jection （ICSI）. METHODS： Retrospective eval- uation of long protocols for those patients under- going IVF/ICSI from 2009 to 2010. Due to the dose of GnRH-a used in luteal metaphase, they were divided into three groups： （0.6 mg （Group A）, ≥0. 6 mg〈0.8 mg（Group B）, ≥0.8 mg（Group C）, in which randomly extract 100 cycles in each group. The clinical outcomes were observed. RESULTS：The transfer cycles of Group A, B, C were 92, 80, 85, respectively. In three groups, there were no significant differ- ences in the rates of maturation, fertilization, high quality embryo, abortion and ectopic preg-nancy（P〉0.05）. The plantation rate and clini- cal pregnancy rate per transfer were also higher in group A than thore group B and C（37.91% vs 25.14% vs 23.16%, 63.04% vs 37.5% vs 41.18%, respectively, P〈0.01）. In group C, the total Gn amount was significantly larger （P 〈0.01）, and the level of LH on Gn day and hCG day were both lower（P〈0.05）, compared with the other two groups. CONCLUSION. Long-actiong GnRH-a in very low dose could get perfect clinical outcome.

关 键 词：体外受精-胚胎移植 促性腺激素释放激素激动剂 长效 

分 类 号：R711.71[医药卫生—妇产科学]