高纯尿促性素应用于IVF超促排卵的初步研究  

Preliminary Exploration of Comparing High Purified hMG with rFSH in Controlled Ovarian Hyperstimulation of IVF Cycles

作　　者：田莉 李娜 师娟子 柏海燕 

机构地区：[1]陕西省妇幼保健院生殖中心,西安710003

出　　处：《生殖与避孕》2014年第11期892-896,共5页Reproduction and Contraception

摘　　要：目的:探讨高纯尿促性素(HP-h MG)对卵巢储备功能正常患者体外受精-胚胎移植(IVFET)促排卵治疗的效果。方法:回顾性分析本中心卵巢储备功能正常且首次进入周期、进行黄体期Gn RH激动剂长方案助孕治疗患者的临床资料,其中使用HP-h MG促排卵者(HP-h MG组)57例,使用重组卵泡刺激素(r FSH组)140例,比较其促性腺激素(Gn)用量、刺激天数、获卵数、种植率、临床妊娠率、h CG注射日雌、孕激素水平以及因卵巢过度刺激综合征(OHSS)风险周期取消率等。结果:HP-h MG组年龄明显高于r FSH组(29.4±3.2岁vs 28.3±3.0岁,P=0.026),其他基础情况组间相似。HP-h MG组Gn总量和刺激天数高于r FSH组,h CG注射日雌、孕激素水平均低于r FSH组,获卵数低于r FSH组,但可用胚胎率高于r FSH组,因OHSS风险而取消周期率低于r FSH组,差异均有统计学意义(P<0.05)。HP-h MG组和r FSH组妊娠率分别为65.3%和61.7%,但无统计学差异。结论:相比r FSH促排卵,HP-h MG作用温和,获卵数少,但可用胚胎率高,发生OHSS风险小,临床妊娠率有增高趋势。Objective： To evaluate the efficacy of highly purified human menopausal gonadotrophin （HP- hMG） in patients with normal ovarian reservation in controlled ovarian hyperstimulation （COH） during IVF cycles. Methods： A retrospective study was carried out in our IVF center. Those patients with normal ovarian reservation who were planned to undergo GnRH-a long protocol treatment were enrolled in this study. Totally 57 patients were performed in HP-hMG group, and 140 patients were performed in recombinant FSH （rFSH） group. The main observational outcomes included total dosage of Gn, duration of ovarian stimulation, the number of oocyte retrieved, implantation rate, clinical pregnancy rate, serum estradiol （E2） level and progesterone （P） level on hCG injection day and cancellation rate due to ovarian hyperstimulation syndrome （OHSS） risk. Results： Compared with rFSH, patients in HP-hMG group was older （29.4± 3.2 years vs 28.3 ± 3.0 years, P=0.026）. Total Gn dosage was higher in HP-hMP group than in rFSH group. Also in HP-hMG group, patients need more time for total stimulation duration. On the day of hCG injection, serum E2 and P levels were lower in HP-hMG group. The number ofoocyte retrieved was less in HP-hMG group but in this group patients had higher embryo available rate than that in rFSH group. HP-hMG group experienced lower cancellation rate to prevent OHSS. Though higher clinical pregnancy rate showed in HP-hMG group （65.3% vs 61.7%）, there was no significantly statistic difference between the two groups. Conclusion： Compared with rFSH, HP-hMG needs higher dosage or longer duration for ovary stimulation, but has lower OHSS risk, higher available embryo rate, and a tendency of higher clinical pregnancy rates.

关 键 词：高纯尿促性素(HP-hMG) 重组促卵泡素(rFSH) 超促排卵 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]