改良超长降调节方案启动日LH、E_2水平与EMs患者IVF-ET结局的关系  

The Effect of serum LH,E_2 level on the day of superovulation start on the prolonged gonadotropin-releasing hormone agonist therapy onthe outcomes of IVF-ET in pation with edometriosis

作　　者：陈益鲁[1] 侯晓红[1] 池海虹[1] 

机构地区：[1]温州医科大学附属第二医院生殖中心,325027

出　　处：《浙江医学》2013年第13期1249-1250,1285,共3页Zhejiang Medical Journal

基　　金：温州市科技局立项项目(Y20120081)

摘　　要：目的探讨改良超长降调节方案启动日LH、E2水平与子宫内膜异位症（EMs）患者体外受精-胚胎移植技术（IVF- ET）结局的关系。方法50例EMs患者（腹腔镜确诊）接受改良超长降调节方案治疗，患者接受GnRH- a治疗3～6个月，每次1.88 mg（1/2支）达菲林肌内注射，间隔28d，第2次注射达菲林后2周开始检测血清CA125，CA125降至18U/L以下后注射末次达菲林1/2支，于末次达菲林注射后2～6周开始用人绝经期促性腺激素（HMG）肌肉注射促进卵泡发育，按启动日血清LH水平分为两组，A1组25例，LH＜0.5U/L,B1组25例，LH≥0.5U/L,比较两组IVF- ET结局。另按启动日E2水平分为两组，A2组E2＜20pg/ml，B2组E2≥20pg/ml，比较两组IVF- ET结局。结果 A1组平均用药天数[（14.71±4.13）d]多于B1组[（8.86±0.49）d]，A1组种植率（24.5%）低于B1组（33.3%）,差异均有统计学意义（均P＜0.05）。A2组与B2组间各项指标未见明显差异。结论改良超长降调节方案治疗EMs患者启动日LH过低将增加HMG用药天数，降低种植率，LH应作为超排启动的主要指标。Objective To evaluate the effect of serum LH,E2 level on the day of superovulation start on the prolonged go-nadotropin- releasing hormone agonist therapy on the outcomes of IVF- ET in patients with edometriosis. Methods Fifty patients received three to six courses of long- acting GnRH agonist, 1.88mg i.m. every 28 days. HMG was started 14~42days later. Con-ventional IVF- ET was performed as routine procedure. All patients were divided into two groups according to the level of serum LH and E2.Group A1 include 25 patients whose level of LH was less than 0.5U/L, Group B1 include 25 patients whose level of LH was over 0.5U/L.The other way , Group A2 include 30 patients whose level of E2 was less than 20pg/ml, Group B2 include 20 pa-tients whose level of E2 was over 20pg/ml. Results The total gonadotropin （Gn） used days were 14.71±5.44 （day） in group A1, more than that in group B1（8.86±0.49 day）. The implantation rate in group A1 （24.5%）was lower than in group B1（33.3%）. Con-clusion If the serum LH,level on the day of superovulation start on the prolonged gonadotropin- releasing hormone agonist thera-py was too low,It maybe decrease the implantation rate,It laso increase the total gonadotropin used days.

关 键 词：子宫内膜异位症 超长方案 促性腺激素释放激素激动剂 体外授精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]