不同促排卵方案在高龄不孕患者IVF-ET中的临床应用  

Application of different ovarian simulation protocols in women with advanced age for IVF-ET

作　　者：王晶[1] 聂明月 杨晓葵[2] 

机构地区：[1]首都医科大学附属北京妇产医院检验科,北京100026 [2]首都医科大学附属北京妇产医院生殖医学科,北京100026

出　　处：《中国优生与遗传杂志》2015年第3期102-104,共3页Chinese Journal of Birth Health & Heredity

基　　金：北京市卫生系统高层次人才培养项目(2011-3-071)

摘　　要：目的对比不同促排卵方案在年龄≥40岁不孕女性体外受精/卵母细胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕中的临床疗效。方法回顾性分析2010年1月至2013年8月于我院生殖中心以促性腺激素释放激素激动剂(Gn RH-a)长方案、Gn RH-a短方案和促性腺激素释放激素拮抗剂(Gn RH-ant)方案促排卵行IVF/ICSI助孕的40岁及以上患者334例,比较各组的IVF结局。结果三组患者的一般情况、HCG日激素水平、受精率、优质胚胎率、周期取消率和临床妊娠率差异均无统计学意义(P>0.05);长方案组获卵数、促性腺激素(gonadotropin,Gn)使用天数和总量显著高于其他两组,差异有统计学意义(P<0.05)。结论高龄不孕患者应用长方案获卵数更高,Gn用量也较大;短方案临床结局较差;拮抗剂方案Gn用量较小但具有较好的临床结局,对于高龄患者可优先考虑。Objective：To explore the clinical value of different ovarian stimulation protocols in patients aged 40 or older for in vitro fertilization/ intracytoplasmic sperm injection-embryo transfer（IVF/ICSI-ET）. Methods：334 women aged 40 or older undergoing IVF/ICSI-ET therapy from January 2010 to August 2013 were analyzed,they were divided into three groups according to different ovarian stimulation protocols. Results：There was no significant difference on the general characteristics,hormone levels on HCG day,fertilization rate,the rate of high quality embryo,cycle cancellation rate and clinical pregnancy rate（P〈0.05）. The retrieval oocytes,the duration and dosage of gonadotropin（Gn）administration of Gn RH-a long protocol group were significantly higher than the other groups（P〈0.05）. Conclusion：In women aged 40 or older,Gn RH-ant protocol is likely to provide a better IVF outcome and ask for less Gn dosage compared with Gn RH-a long and short protocols.

关 键 词：高龄 体外受精-胚胎移植 促排卵方案 

分 类 号：R714.8[医药卫生—妇产科学]