长、短效GnRH激动剂在卵巢储备低下患者行体外受精-胚胎移植长方案周期中的效果比较  

Comparison of the effect of short- acting and long- acting gonadotropin- releasing hormone agonists in long protocol of IVF- ET for patients with poor ovarian reserve

作　　者：熊永崂[1] 杨桂艳[1] 杨嫦玉[1] 吴重聪[1] 

机构地区：[1]珠海市妇幼保健院生殖中心,广东珠海519000

出　　处：《中国计划生育和妇产科》2015年第12期15-18,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：珠海市医学科研基金项目(项目编号:409239354035)

摘　　要：目的探讨长效和短效促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,GnRH-a)在卵巢储备低下患者行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)长方案周期中的应用及对临床结局的影响。方法回顾性分析2013年全年珠海市妇幼保健院生殖中心使用长方案超排卵治疗的卵巢储备低下患者IVF-ET周期112例,根据使用不同剂型的GnRH-a,分成GnRH-a短效组(80例)和长效组(32例)。对两组间垂体降调节效果、促排卵过程中激素水平、促性腺激素(gonadotropins,Gn)使用时间、剂量及IVF-ET结局进行比较。结果短效组人绒毛膜促性腺激素(Human chorionic gonadotropin,HCG)日黄体生成素(luteinizing hormone,LH)为(2.46±1.29)IU/L,孕酮(Progesterone,P)为(2.02±0.65)nmol/L,Gn使用天数为(11.56±1.7)d;长效组HCG日LH为(1.56±2.46)IU/L,P为(2.55±1.14)nmol/L,Gn使用天数为(13.03±1.91)d,两组比较差异有统计学意义(P<0.05)。短效组种植率32.98%(31/94),临床妊娠率48.14%(26/54);长效组种植率22.92%(11/48),临床妊娠率为37.50%(9/24),两组比较差异无统计学意义(P>0.05)。结论短效GnRH激动剂长方案对垂体抑制作用较弱,可能增加卵巢储备低下患者行IVF-ET的胚胎种植率和临床妊娠率。Objective To compare the effects and clinical results of short- acting and long- acting gonadotropin- releasing hormone agonists in long protocol of in- vitro fertilization- embryo transfer（ IVF- ET） for patients with poor ovarian reserve. Methods A total of 112 cycles of IVF- ET in long protocol for patients with poor ovarian reserve in Zhuhai Maternity and Child Health Hospital from Jan 2013 to Dec 2013 were retrospectively analyzed. All cases were divided into short- acting group and long- acting group according to using short- acting or long- acting GnRH agonist. Down regulation effects,hormone levels in controlled ovarian stimulation（ COH）,Gn days,total Gn doses,endometrium,and outcomes of IVF- ET were compared. Results In short- acting group,the serum luteinizing hormone（ LH）,Progesterone（ P）,Gn days were（ 2. 46 ± 1. 29） IU / L,（ 2. 02 ± 0. 65） nmol / L,（ 11. 56 ± 1. 7） days respectively,while in long- acting group were（ 1. 56 ± 2. 46） IU/L,（ 2. 55 ± 1. 14） nmol/L,（ 13. 03 ± 1. 91）days,the differences between two groups had statistical significances（P〈0. 05）. Embryo implanting rate and clinical pregnant rate in short- acting group were 32. 98 %（ 31 /94）,48. 14 %（ 26 /54）,while in long- acting group were 22. 92 %（ 11 /48）,37. 50 %（ 9 /24） respectively,the differences between two groups had no statistical significance（P〈0. 05）. Conclusion The short- acting GnRH agonist in long protocol had a weak effect in down regulation which may increase embryo implanting rate and clinical rate.

关 键 词：促性腺激素释放激素激动剂 体外受精-胚胎移植 卵巢储备低下 长方案 

分 类 号：R715[医药卫生—妇产科学]