戊酸雌二醇联合坤泰胶囊在体外受精卵巢低反应患者中的应用  

The Combined Application of Estradiol Valerate-Cyproterone Acetate and Kuntai Capsule in Poor Ovarian Responders of in Vitro Fertilization

作　　者：李巍巍[1] 安丽红[1] 张歌[1] 王兴玲[1] 孙丽君[1] 管一春[1] 娄华[1] 袁恩武[1] 

机构地区：[1]郑州大学第三附属医院生殖中心,河南郑州450052

出　　处：《实用妇产科杂志》2014年第9期681-685,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨戊酸雌二醇(克龄蒙)联合坤泰胶囊在体外受精(IVF)卵巢低反应患者(POR)中应用的价值。方法:选取在郑州大学第三附属医院生殖中心行体外受精-胚胎移植(IVF-ET)中出现POR的患者,在进入第2周期IVF助孕前,随机筛选80例,分为对照组、克龄蒙组、坤泰组及联合组(克龄蒙加坤泰胶囊),每组各20例。分别给予克龄蒙、坤泰胶囊及联合用药的预处理3个月经周期,对照组未特殊处理。测定4组预处理前后常用的卵巢储备功能指标及第1、2周期助孕周期监测指标,并进行比较。结果:1预处理后克龄蒙组、坤泰组、联合组与自身预处理前和对照组的卵巢储备功能指标比较,FSH及LH水平下降,抗苗勒管激素(AMH)及收缩期峰值流速(PSV)上升,差异均有统计学意义(P<0.05)。预处理后联合组与克龄蒙组相比,FSH水平降低、AMH及PSV升高(P<0.05);与坤泰组相比,FSH及LH水平降低、AMH升高(P<0.05)。2经预处理后第2周期与第1周期的助孕情况比较,克龄蒙组患者的HCG日E2水平上升(P<0.05);坤泰组Gn用量和Gn天数降低(P<0.05);联合组Gn用量、Gn天数降低,HCG后日E2水平、获卵数和优质胚胎数均增加(P<0.05)。第2周期中联合组与克龄蒙组相比,获卵数增加、优质胚胎数增加(P<0.05);与坤泰组相比,HCG日E2水平增加、优质胚胎数增加(P<0.05)。结论:克龄蒙联合坤泰胶囊在POR患者中的应用效果优于单独使用,能提高POR患者卵巢储备功能,改善IVF结局。Objective： To investigate the combined application of estradiol valerate-cyproterone acetate and Kuntai capsule to poor ovarian responders（POR） of in vitro fertilization （IVF）. Methods： Eighty patients with POR after receiving IVF treatment in reproductive center of the Third Affiliated Hospital of Zhengzhou University were randomly grouped into 4 groups as follow： control group （ n = 20 ）, Climen group （ n = 20）, Kuntai capsule group（ n =20）and Climen combined with Kuntai capsule group（ n =20）. Treatment were used for three menstrual cycles before the next cycle. The indexes of ovarian reserve function were tested before and after treatment,and the indexes of assisted reproduction cycle monitoring were compared between the first cycle and the second cycle. Results：①After treatment, the levels of FSH and LH in Climen group, Kuntai group and combined group significantly decreased, and the levels of AMH and PSV significantly increased （ P 〈 0.05）. In combined group, FSH was lower and AMH and PSV were higher than Climen group （ P 〈 0.05）. In combined group,FSH and LH were lower and AMH was higher than Kuntai group（P〈0.05）.② Compared with the first cycle,the E2 value on the HCG day in Climen group of the second cycle increased （P〈0.05）. The amount of Gn and Gn days in Kuntai group of the second cycle decreased（ P 〈0. 05）. In combined group of the second cycle,the amount of Gn,days of Gn decreased,and the E2 value of the HCG day,the number of oocytes and good embryos increased（ P 〈0.05）. In the second cycle,compared with Climen group,the number of oocytes and good embryos in combined group increased （ P 〈 0.05）. Compared with Kuntai group,the E2 value of the HCG day and the number of good embryos in combined group increased（ P 〈 0.05）. Conclusions .. Treatment with Climen combined with Kuntai capsule can effectively improve the ovarian reserve in POR patients and subsequently improve the outcome of IVF, superior to treat- ment with Kun

关 键 词：卵巢低反应 体外受精 戊酸雌二醇 坤泰胶囊 微刺激 

分 类 号：R711.6[医药卫生—妇产科学]