三种促排卵药物在体外受精／卵胞质内单精子注射－胚胎移植的临床疗效分析  

Comparison of clinical efficacy of three different gonadotropins in controlled ovarian hyperstimulation during IVF-ET cycles

作　　者：张雯碧[1] 陈国武[1] 孙晓溪[1] 李路[1] 

机构地区：[1]复旦大学附属妇产科医院,上海集爱遗传与不育诊疗中心,上海200011

出　　处：《生殖与避孕》2015年第1期22-29,共8页Reproduction and Contraception

摘　　要：目的:比较体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)控制性超促排卵(COH)中3种不同促排卵药物的临床疗效。方法:回顾性分析行IVF/ICSI治疗的3种COH方案[短方案、长方案与克罗米芬(CC)+促性腺激素(Gn)方案]不孕症患者的3 347个移植周期的临床资料。3种COH方案内再各分为3个组,分别为高纯度尿促性素(HP-h MG)组、人尿促性素(h MG)组、重组卵泡刺激素(r FSH)组。比较3组患者给予Gn的时间、Gn用量、人绒毛膜促性腺激素(h CG)注射日雌二醇(E2)、孕酮(P)水平及子宫内膜厚度、获卵数、受精率、卵裂率、有效胚胎率、平均移植胚胎数、临床妊娠率和种植率。结果:h MG组无论在Gn使用的天数和剂量上,都显著高于HP-h MG组与r FSH组。在CC+Gn方案中,HP-h MG组在h CG注射日E2峰值最低。在长方案中,HP-h MG组h CG注射日的P水平最低(P<0.05)。3种方案中各组的h CG注射日子宫内膜厚度、获卵数、受精率、卵裂率、有效胚胎率、平均移植胚胎数、临床妊娠率与种植率比较,均无统计学差异(P>0.05)。结论:HP-h MG在h CG注射日具有较低P水平,使得内膜更利于胚胎着床,其COH临床效果上与其他促排卵药物一样有效、安全。Objective： To compare the clinical efficacy of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET） with three different gonadotropins （Gn） for controlled ovarian hyper- stimulation （COH）. Methods： A total of 3 347 IVF/ICSI-ET cycles in infertility patients were analyzed retrospectively. They were divided into three different Gn groups according to three different ovarian stimulation protocols （short/long/CC＋Gn）： HP-hMG group, hMG group and rFSH group. The clinical outcomes were com- pared among the three groups in the same protocols. Results： The total dosage and days of Gn used in hMG group were significantly more than those in the other two groups （P〈0.05）. The estradiol level on hCG injection day in HP-hMG group was lower than that in other groups in CC＋Gn protocol, and the progesterone level on hCG injection day was also lower in HP-hMG group than in other groups in long protocol （P〈0.05）. The endometrial thickness, the numbers of retrieved oocytes, the fertilization rate, the cleavage rate, the embryos survival rate, the number of embryos transferred, the clinical pregnancy rate and the implantation rate were not significantly different among the three groups （P〉0.05）. Conclusion： The lower progesterone level on hCG injection day in HP-hMG group contributes to higher rate of embryo implantation. The HP-hMG has the same effectiveness and safety as other Gn in ovarian stimulation in IVF-ET cycles.

关 键 词：体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET) 控制性超促排卵(COH) 促性腺激素(Gn) 临床结局 

分 类 号：R714.8[医药卫生—妇产科学]