改良长方案对体外受精-胚胎移植患者累计妊娠率和活产率的回顾性分析  

A retrospective analysis of prolonged pituitary down-regulation with gonadotropin-releasing hormone agonist improve the cumulative pregnancy rate and the live-birth rate in in vitro fertilization treatment

作　　者：韩艳[1] 邓星[1] 蔡嘉力[1] 任建枝[1] 沙爱国[1] 韩冬梅[1] 

机构地区：[1]解放军第174医院生殖中心,福建厦门361003

出　　处：《中国优生与遗传杂志》2015年第7期102-105,共4页Chinese Journal of Birth Health & Heredity

基　　金：厦门市科技平台基金资助项目;项目编号:3502z20111006

摘　　要：目的回顾性分析采用改良长方案和经典长方案控制性超促排卵的不孕症患者妊娠结局,以评估改良长方案对体外受精-胚胎移植患者的累计妊娠率和活产率的影响。方法收集我院2008年-2012年因输卵管盆腔因素行体外受精-胚胎移植患者的病例资料,根据促排卵方案分为改良长方案(931例)与经典长方案(370例)两组,比较两组患者的累计妊娠率和活产率。结果 1.改良长方案组新鲜周期活产率(54.84%)明显高于经典长方案组(33.03%),有显著统计学意义(P<0.001)。2.上述患者中共有348例改良长方案和179例经典长方案行解冻复苏移植周期,改良长方案组活产率(48.28%)高于经典长方案组(32.40%),有显著统计学意义(P<0.001)。3.改良长方案组周期累计妊娠率(74.86%)与经典长方案组比较,(70.27%)无统计学差异(P=0.334),但改良长方案组累计活产率(63.05%)高于经典长方案组(44.86%),有显著统计学意义(P<0.001)。结论改良长方案不能增加患者的周期妊娠率,但可以提高患者的周期活产率。Objective：To evaluate the effects of a prolonged duration of gonadotropin-releasing hormone agonist（Gn RH-a）in pituitary downregulation for controlled ovarian hyperstimulation（COH）on the cumulative pregnancy rate and live-birth rate in women for tuber and pelvic factors undergoing in vitro fertilization and embryo transfer（IVF-ET）.Methods：Design：Retrospective cohort study.Setting：The 174 th hospital of PLA.Patient：women for tuber and pelvic factors undergoing IVF. Intervention（s）：931 patients receiving a prolonged pituitary down-regulation with Gn RH-a before ovarian stimulation and 370 patients receiving a Gn RH-a long protocol.there are 383 frozen-thawed embryo transfer cases of prolong protocol and 179 frozenthawed embryo transfer cases of long protocol.Main Outcome Measure（s）：Cumutative pregnancy rate and live-birth rate per OPU cycle.Result（s）：In comparison with the long protocol,the prolonged down-regulation protocol required a higher total dose of gonadotropins. A lower serum luteinizing hormone（LH）level on the starting day of gonadotropin and the day of human chorionic gonadotropin（h CG）,a higher serum estrol（E2）on the day of h CG and a fewer number of oocytes and embryos were observed in the prolonged down-regulation protocol. However,the duration of stimulation and number of high-quality embryos were comparable between the two groups.The pregnancy rate in fresh cycle and the cumulative pregnancy rate were comparable,but a statistically significantly higher live-birth rate per fresh transfer cycle（54.84% vs. 33.03%）and cumulative live-birth rate（63.05% vs. 44.86%）were observed in the prolonged protocol.Conclusion：Prolonged down-regulation in a Gn RH-a protocol might increase the live-birth per fresh transfer cycle and the cumulative live-birht rate in women for tuber and pelvic factors undergoing IVF.

关 键 词：改良长方案 经典长方案 累计妊娠率 活产率 

分 类 号：R714.8[医药卫生—妇产科学]