体外受精-胚胎移植治疗中促排卵药物的剂量选择及对妊娠结局的影响  

The Dose Selection of Ovulation-Inducing Drugs and Its Effect on Pregnancy Outcomes in Treatment of IVF-ET

作　　者：毛增辉[1] 罗树伟[1] 康革华[1] 

机构地区：[1]湖南省计划生育研究所,湖南长沙410000

出　　处：《临床医学工程》2016年第2期207-208,共2页Clinical Medicine & Engineering

摘　　要：目的 探讨体外受精-胚胎移植（IVF-ET）治疗中促排卵药物（Gn）的剂量选择及对妊娠结局的影响。方法 回顾性分析1 647例IVF-ET患者（共1 647个周期）的临床资料,按照Gn启动剂量的不同将其分为A（112.5 IU）、B（150 IU）、C（187.5~225 IU）、D（262.5 IU）、E（300 IU）五组,比较各组的妊娠结局。结果 各组平均年龄、不孕年限、基础E2和FSH水平、Gn使用时间、受精率比较均无显著差异（P〉0.05）。A、B、C组随着Gn剂量的增加,其获卵数、h CG阳性率、临床妊娠率比较差异不显著（P〉0.05）;D、E组分别与A组比较,随着Gn剂量的增加,其获卵数也相应增多,同时其h CG阳性率和临床妊娠率则相应下降（P〈0.05）。结论 对于卵巢储备正常的年轻患者,高剂量Gn能使患者获卵数增多,而受精率无明显变化,但过高剂量的Gn降低妊娠率,影响受精胚胎的发育潜能,临床实践中应以不超过225 IU/d为宜,以获得较高的临床妊娠率。Objective To investigate the dose selection of ovulation-inducing drugs（Gn） and its effect on pregnancy outcomes in treatment of IVF-ET. Methods The clinical data of 1 647 IVF-ET patients（1 647 cycles） were retrospectively analyzed. All patients were divided into group A（112.5 IU）, group B（150 IU）, group C（187.5 - 225 IU）, group D（262.5 IU） and group E（300 IU） according to different starting doses of Gn. The pregnancy outcomes were compared between these groups. Results The average age, duration of infertility, basal E2 levels, basal FSH levels, usage time of Gn, fertilization rate of five groups had no significant difference（P〉0.05）. With the increasing doses of Gn, the numbers of retrieved oocytes, h CG positive rate and clinical pregnancy rate of group A, B, C had no statistical difference（P〉0.05）; with the increasing doses of Gn, compared with group A, the numbers of retrieved oocytes of group D, E increased significantly, and the h CG positive rate and clinical pregnancy rate decreased significantly（P〈0.05）. Conclusions For young patients with normal ovarian reserve, high-doses of Gn can increase the numbers of retrieved oocytes, while the fertilization rate has no significant change;but excessive Gn can reduce the pregnancy rate, affect the developmental potential of fertilization embryos. In order to obtain higher clinical pregnancy rate, we should choose Gn ≤225 IU/d in clinical practice.

关 键 词：促性腺激素 体外受精-胚胎移植 妊娠率 临床结局 

分 类 号：R711.6[医药卫生—妇产科学]