200 IU hCG替代hMG在晚卵泡期应用于控制性卵巢刺激的疗效观察  

Effect of 200 IU hCG Replacing hMG in the Late Follicular Phase of Controlled Ovarian Stimulation for IVF Cycle

作　　者：傅永伦[1] 章晓乐[1,2] 汪云[1] 康艳[1] 吕祁峰[1] 匡延平[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院辅助生殖科,上海200011 [2]上海中医药大学附属曙光医院妇科,上海201203

出　　处：《生殖与避孕》2014年第3期205-209,共5页Reproduction and Contraception

摘　　要：目的:探讨200 IU hCG在控制性卵巢刺激(COS)过程的晚卵泡期替代hMG对COS的疗效。方法:回顾性分析行体外受精/单精子卵胞质内注射-冻融胚胎移植(IVF/ICSI-FET)患者资料共154例,进行154个COS周期,根据晚卵泡期是否应用200 IU hCG分为:A组,COS完全应用hMG(65个周期);B组,COS的早卵泡期应用hMG,晚卵泡期则应用hCG(200 IU/d)替代hMG(89个周期)。后续166个周期进行FET,其中,A组70个周期,B组96个周期。统计分析COS周期的用药情况、IVF/ICSI-FET结局。结果:B组的hMG用药剂量和用药时间分别显著少于A组(1 361.0±494.6 IU vs 1 782.7±475.2 IU,P<0.05;7.3±2.3 d vs 9.5±2.0 d,P<0.05);B组的成熟卵母细胞数显著多于A组(15.2±6.6 vs 11.6±5.7,P<0.05);冻融胚胎移植中A、B组的临床妊娠率(64.29%vs 64.58%,P>0.05)及活产率(80.00%vs 79.03%,P>0.05)比较无统计学差异。结论:200 IU hCG能够在COS的晚卵泡期替代hMG,能安全、有效地维持卵泡生长发育,并且减少Gn的用量,避免卵巢过度刺激综合征(OHSS)发生。Objective： To explore whether low-dose hCG can be used clinically to replace hMG during the late follicular phase in controlled ovarian stimulation （COS） for IVF cycle. Methods： A total of 154 IVF/ICSI patients undergoing COS in a short-term protocol were divided into two groups： group A, hMG throughout COS （65 cycles）; group B, ovarian priming with hMG followed by low-dose hCG （200 IU/d） alone （89 cycles）. After COS, 166 FET cycles had been undergone. Results： Mean values for dose and duration of hMG treatment in group B versus group A were 1 361.0±494.6 IU vs 1 782.7 ± 475.2 IU （P〈0.05）, and 7.3± 2.3 d vs 9.5 ± 2.0 d （P〈 0.05）, respectively. The mean number of metaphase II oocytes in group B was higher than that in group A （15.2±6.6 vs 11.6±5.7, P〈0.05）. Clinical pregnancy rate, live birth rate of FET in group A were not significantly different from group B （64.29% vs 64.58%, P〉0.05） （80.00% vs 79.03%, P〉0.05）. Conclusion： Replacing of hMG by low-dose hCG （200 IU） in the late phase of COS can complete stimulate safely and effectively, which leads to a reduction of Gn consumption and avoids the incidence of ovarian hyperstimulati0n syndrome （OHSS）.

关 键 词：HCG 小剂量 控制性卵巢刺激(COS) 体外受精 单精子卵胞质内注射 冻融胚胎移植(IVF ICSI—FETl 

分 类 号：R714.8[医药卫生—妇产科学]