IVF-ET中卵巢低反应患者拮抗剂方案中应用生长激素的研究  

Application of growth hormone to the poor ovarian responders during in vitro fertilization and embryo transfer antagonist protocol

作　　者：吴洪波[1] 李柳铭 李慕军[1] 罗江霞[2] 

机构地区：[1]广西医科大学第一附属医院生殖医学研究中心,南宁530021 [2]广西柳州市人民医院生殖医学研究中心,柳州545006

出　　处：《生殖与避孕》2016年第5期416-420,共5页Reproduction and Contraception

基　　金：广西医疗卫生重点项目(体外受精与胚胎移植相关研究);项目号:重200101

摘　　要：目的:研究卵巢低反应(POR)患者采用拮抗剂方案加用生长激素(GH)对子宫内膜容受性及妊娠结局的影响。方法:对采用拮抗剂方案促排卵行体外受精-胚胎移植(IVF-ET)助孕的188例POR患者的资料进行回顾性分析。以加用GH者为研究组(n=98),其余不加用GH者为对照组(n=90),比较组间的临床资料、实验室数据及妊娠结局,以评估GH治疗对POR患者的临床疗效。结果:研究组的Gn使用时间、Gn RH-A使用时间及总Gn使用量显著少于对照组,而获卵数、MII卵子数、受精卵数、优质胚胎数、h CG注射日血E2水平均显著高于对照组,差异均有统计学意义(P<0.05);h CG注射日子宫内膜厚度组间比较差异无统计学意义(P>0.05),但研究组子宫内膜血流改善显著,差异有统计学意义(P<0.05);研究组生化妊娠率、临床妊娠率、种植率、活产率略高于对照组,但差异无统计学意义(P>0.05)。结论:对于POR患者,GH改善了子宫内膜血流,可能提高了子宫内膜容受性,但对妊娠结局没有改善。Objective： To investigate the influence of applying the growth hormone （GH） to the endometrial receptivity and the outcome of pregnancy to the poor ovarian responders during in vitro fertilization and embryo transfer （IVF-ET） antagonist protocol. Methods： A total of 188 patients undergoing IVF-ET were collected and analyzed who all had poor ovarian response （POR） and antagonist protocol. Among them, 98 cases added GH were served as research group, other 90 patients without addition of GH were acted as control group. Results： The duration of gonadotropin treatment, duration of GnRH antagonist treatment, and dose of gonadotropin were significantly lower in research group than in control group, while the mean E2 levels on the day ofhCG administration, number of retrieved oocytes, number of metaphase II oocytes, numbers of fertilized oocytes and high-quality embryos were significantly higher in research group than in control group; there was no significant difference between the two groups with regard to endometrial thickness on injection day, but the endometrial blood flow was significantly improved in research group, the difference was statistically significant; the biochemical pregnancy rate, the clinical pregnancy rate, the implan- tation rate and the live birth rate in research group were higher than those in control group, but the difference was not statistically significant. Conclusion： GH can improve the endometrial blood flow and maybe increase the endometrial receptivity, but the outcome of pregnancy is not improved in poor ovarian responders.

关 键 词：拮抗剂方案 生长激素(GH) 体外受精-胚胎移植OVF—ET) 卵巢低反应(POR) 子宫内膜容受性 

分 类 号：R714.8[医药卫生—妇产科学]