促性腺激素释放激素激动剂联合人绒毛膜促性腺激素诱导卵泡成熟在拮抗剂方案中的疗效比较  

Comparison of efficacy between combined trigger of GnRHa and HCG and single trigger of GnRHa in the GnRH antagonist protocol

作　　者：郭萍萍[1] 陈薪[1] 刘玉东[1] 叶德盛[1] 冯淑娴[1] 陈士岭[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖医学中心,广州510515

出　　处：《广东医学》2016年第9期1373-1375,共3页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81170574;81401177);广东省自然科学基金资助项目(编号:2015A030313286)

摘　　要：目的探讨促性腺激素释放激素(GnRH)拮抗剂促排卵方案中联合使用GnRH激动剂(GnRHa)和人绒毛膜促性腺激素(HCG)诱导卵泡成熟治疗的安全性和有效性。方法采用回顾性病例对照研究设计,回顾性分析因多囊卵巢综合征和输卵管因素复合病因行GnRH拮抗剂方案并联合GnRHa和HCG诱导卵泡成熟治疗的不孕症患者(A组),共41个体外受精(IVF)周期。同期根据年龄、体质指数(BMI)和不孕症病因配对41个IVF周期,行GnRH拮抗剂方案并使用GnRHa诱导卵泡成熟(B组)作对照。结果两组基础FSH水平、获卵数和优质胚胎数的差异无统计学意义(P>0.05)。A组临床妊娠率和活产率均高于B组,但差异无统计学意义(P>0.05)。A组新鲜周期取消率高于B组但差异无统计学意义(P>0.05)。两组移植后均无卵巢过度刺激综合征(OHSS)发生。结论对于非OHSS超高危患者,GnRH拮抗剂方案中联合GnRHa和HCG诱导卵泡成熟较单用GnRHa诱导卵泡成熟可以部分提高临床妊娠率和活产率,但不会显著增加OHSS发生率。Objective To investigate the safety and efficacy of gonadotropin releasing hormone agonist （GnRHa） combined with human chorionic gonadotropin （HCG） in GnRH antagonist protocol. Methods A retrospective case - con- trol study was performed. Cases in Group A included 41 IVF cycles on the GnRH antagonist protocol with GnRHa com- bined with HCG. The patients in Group A had only polycystic ovary syndrome and tubal infertility. Group B was matched with Group A according to age, body mass index （BMI） and the cause of infertility. The GnRH antagonist protocol in Group B used single trigger of GnRHa. Results There was no significant difference between the two groups inbasal FSH level, number of oocytes collected and number of high quality embryos （ P 〉 0. 05 ）. The clinical pregnancy rate and live birth rate in Group A were higher than those of Group B, but the difference was not statistically significant （ P 〉 0. 05 ）. The cancellation rate of fresh embryo - transfer in Group A was higher than that in Group B without statistical significance （P 〉 0. 05）. No OHSS occurred in the two groups. Conclusion For patients without ultra - high OHSS risk, trigger with GnRHa combined with HCG may not increase the OHSS rates, but may be helpful to increase the clinical pregnancy rate and live birth rate.

关 键 词：体外受精-胚胎移植 促性腺激素释放激素激动剂 拮抗剂 人绒毛膜促性腺激素 临床妊娠率 

分 类 号：R711.71[医药卫生—妇产科学]