改良超长方案在体外受精-胚胎移植中的应用  

Clinical application of modified super-long program in patients in IVF-ET

作　　者：孙丽君[1] 孙革青 董孝珍[1] 宋娜[1] 马晓娟[1] 胡继君[1] 

机构地区：[1]郑州大学第三附属医院生殖中心,450052

出　　处：《中国实用医刊》2014年第7期7-9,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨改良超长方案在体外受精一胚胎移植的患者中的临床应用情况。方法回顾性分析在郑州大学第三附属医院生殖中心行体外受精一胚胎移植的卵巢反应稍低患者95例。50例应用改良超长方案（A组），其中15例第一次长方案未孕后用改良超长方案，另35例为子宫内膜异位症患者；45例应用长方案（B组）；15例患者第一次用长方案未成功，后应用改良超长方案，分别归为C组和D组进行自身对照分析。分别计算A、B、C、D组患者Gn使用剂量、天数、人绒毛膜促性腺激素（HCG）日激素水平及内膜厚度、获卵数、受精率、卵裂率、优胚率、临床妊娠率、流产率，并进行统计学分析。结果①A、B两组患者的年龄、不孕年限、体质量指数、各基础内分泌激素水平及双侧窦卵泡数组间比较差异均无统计学意义（P〉0．05）；②A组Gn使用天数、HCG注射日子宫内膜厚度高于B组（P〈0．05）；B组HCG注射日促黄体生成素（LH）水平高于A组（P〈0．05），患者Gn用量、HCG注射日雌三醇（E：）及孕激素（P）组间比较差异无统计学意义（P〉0．05）；③A、B两组患者获卵数、周期取消率、受精率、卵裂率、优质胚胎率、临床妊娠率、流产率组间比较差异均无统计学意义（P》0．05）；④D组Gn使用天数、HCG注射日子宫内膜厚度高于C组（P〈0．05），D组HCG注射日LH水平低于C组（P〈0．05），C、D组患者Gn用量、HCG注射日E2及P组间比较差异无统计学意义（P〉0．05）；⑤C、D组患者获卵数、周期取消率、受精率、卵裂率、优质胚胎率组间比较差异均无统计学意义（P〉0．05），D组中临床妊娠率为33．33％，这些患者在第1次长方案时均未妊娠。结论对卵巢配备稍低和子宫内膜异位症的患者改良超长降调节方案是一种较好的促排方案。Objective To investigate the clinical application of the modified super-long down- regulation protocol in patients with inviro fertilization-embryo transferation （IVF-ET）. Methods The clinical data of 95 patients with lower ovarian reponse underwent IVF-ET were analyzed retrospectively. Among them, 50 cases （group A ） accepted modified super-long down-regulation protocol, 45 cases （group B ） accepted long down-regulation protocol. Fifteen patients in group A were given first long down-regulation protocol without success（ group C） , and then were given modified super-long down-regu- lation protocol（Group D）. The duration of stimulation, total dose of Gn, E2 level on HCG day, number of eggs retrieved, rate of high quality embryo, clinical pregnancy rate were compared between the groups. Results ①There were no significant differences in age, infertility duration, BMI, various endocrine hormone levels or the number of the bilateral antral follicle （ P 〉 0.05 ）. ②The days of using Gn, endom- etrial thickness on HCG injecting day in group A were higher than those in group B （ P 〈 0.05 ）, the level of LH on HCG injecting day in group A was lower than that in group B （ P 〈 0.05 ）, there were no signifi- cant differences in the dosage of Gn, E2 and P levels on HCG injecting day between the two groups （P 〉 0.05 ）. ③There were no significant differences in the number of oocyte, the rate of cancellation, the rate of fertilization, the rate of cleavage, the rate of high-quality embryo or clinical pregnancy rate （P 〉 0. 05 ） between the two groups. ④The days of using Gn, endometrial thickness on HCG injecting day in group D were higher than those in group C （P 〈 0.05 ）, the level of LH on HCG injecting day in group D was lower than that in group C （ P 〈 0.05 ）. ⑤ There were no significant differences in the number of oo- cyte, the rate of cancellation, the rate of fertilization, the rate of cleavage, the rate of high-quality em- bryo or clinical pregnancy

关 键 词：改良超长方案 长方案 体外受精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]