重组人生长激素对高龄妇女不同超促排卵方案IVF-ET结局的影响  

Effect of administration of recombinant human growth hormone in advanced age women receiving IVF-ET with different control ovarian stimulation protocols

作　　者：庄丽丽[1] 郝翠芳[1] 张宁[1] 葛丽[1] 

机构地区：[1]山东烟台毓璜顶医院生殖医学中心,烟台市264000

出　　处：《生殖医学杂志》2013年第12期918-921,共4页Journal of Reproductive Medicine

摘　　要：目的观察高龄妇女(≥35岁)患者不同促排卵方案体外受精-胚胎移植(IVF-ET)治疗周期中添加重组人生长激素(GH)辅助超排卵的临床应用效果。方法对2010年1月至2012年12月在我中心行微量长方案及长方案促排卵的IVF-ET高龄患者,随机分为两组,其中研究组加用GH,对照组未用GH,两组患者启动剂量均为福特蒙300U,分析两组获卵数、人绒毛膜促性腺激素(HCG)日内膜厚度、HCG日内膜形态、受精率、卵裂率、优胚率及妊娠率的差异。结果两种促排卵方案中研究组与对照组相比较受精率均明显增高,有显著差异(P<0.05),妊娠率有增高趋势,但无显著差异,其中长方案促排卵研究组优质胚胎率较对照组明显升高,微量长方案促排卵研究组优质胚胎率无此趋势,两种促排卵方案中研究组与对照组中获卵率、卵裂率、HCG日内膜厚度、HCG日内膜形态、优质胚胎率均无明显差异。结论对高龄患者行IVF-ET治疗中使用GH可以显著提高受精率,并有增加优质胚胎率及妊娠率的趋势;针对不同年龄或卵巢功能状态,个体化调整GH剂量可能更可行。Objective： To observe the clinical effects of administration of recombinant human growth hormone （GH） in advanced age women receiving IVF-ET（in-vitro fertilization and embryo transplantation）with different control ovarian hyperstimulation protocols. Methods： A total of 231 patients with age 35 years who underwent control ovarian hyper stimulation with standard long protocol or long protocol with mild down-regulation from January 2010 to December 2012 were randomized into two groups. The patients in study group were administered 4 IU GH with the starting daily dose of 300 IU Fostimon, while the follicular stimulation was only continued with 300 IU Fostimon in control group. Oocyte retrieval rates,thickness and patterns of endometrium on HCG day, fertilization rate,cleavage rate,high qualified embryo rate and pregnancy rate were compared between the two groups. Results： Compared with that in the control group,the fertilization rate was significantly higher（P〈0.05）and the pregnancy rate was slightly higher in study group （ P〈 0. 05 ）. For women treated with standard long protocol, the high qualified embryo rate in study group showed a slight increase, while no slight increase was observed in women receiving long protocol with mild down-regulation. There were no significant differences in oocyte retrieval rates,the thickness and pattern of endometrium on HCG day, andcleavage rate between the two groups. Conclusions： Usage of GH tor advanced age women receiving IVF-ET significantly improves the fertilization rate, and might have advantage to raise high qualified embryo rate and pregnancy rate. Addition of GH should be individualized according to the age and ovarian reservation.

关 键 词：重组人生长激素 微量长方案 标准长方案 受精率 卵裂率 优胚率 妊娠率 

分 类 号：R[医药卫生]