控制性超促排卵后卵巢慢反应与体外受精结局的关系的研究  

Correction between the in- vitro fertilization outcome and slow ovarian response during controlled ovarian stimulation

作　　者：张鑫[1] 罗清炳[1] 徐鸿毅[1] 张昌军[1] 

机构地区：[1]湖北医药学院附属十堰市人民医院生殖医学中心,湖北十堰442000

出　　处：《中国性科学》2016年第6期114-117,共4页Chinese Journal of Human Sexuality

摘　　要：目的:分析控制性超促排卵后卵巢慢反应与体外受精结局的关系,探讨外源性重组黄体生成素(r LH)等相关因素在其中的作用。方法:选取2010年1月到2013年1月在本院生殖医学中心行IVF治疗的260不孕患者为研究对象。根据促排卵的反应和治疗状况将其分为三组:A组,增加r FSH剂量,同时给予r LH补充治疗的卵巢慢反应患者,共89例;B组,仅单一增加r FSH用量的卵巢慢反应患者,共73例;C组,对照组,同期卵巢反应正常的患者,共98例。分析比较三组启动日和刺激第8d的LH水平、促排卵时间、Gn总用量、HCG日E2和LH水平、获卵数、受精率、正常受精率、卵裂率、优胚率、胚胎种植率、临床妊娠率、早期流产率等。结果:A、B组的Gn使用总时间、Gn总用量明显高于C组,HCG日LH水平、HCG日E2水平和获卵数则明显低于C组,差异具有统计学意义(P<0.05/P<0.01);同时,A组HCG日E2水平、获卵数亦高于B组(P<0.05);B组临床妊娠率、胚胎种植率均明显低于C组(P<0.05)。其余各项指标三组间均无统计学差异。结论:相比于卵巢反应正常者,控制性超促排卵中卵巢慢反应患者的体外受精结局较差。补充外源性r LH则可有效改善卵巢反应性、改善治疗结局。Objectives： To analyze the in- vitro fertilization（ IVF） outcome of women with slow ovarian response during controlled ovarian stimulation and explore the effect of recombinant human luteinizing hormone（ LH）on it. Methods： 260 infertility patients in our hospital Reproductive Medical Center from January 2010 to January2013 for IVF treatment were selected as the research objects and divided into three groups according to the ovarian response and treatment. Patients with slow ovarian response in group A（ n = 89） were given r LH 75 IU / day to150 IU / day from the eighth day of stimulation,with increasing dose of r FSH. Patients in group B（ n = 73） only received increased dose of r FSH. Group C（ n = 98） served as control group with normal ovarian response. LH levels on stimulating 1st and 8th days,the total amount and time of gonadotropin（ Gn） administration,the serum LH and E levels on the day of injection of human chorionic gonadotropin（ HCG）,number of oocytes retrieved,the outcome of fertilization and pregnancy were observed. Results： Gn administration time and dose in group A and B was higher than that of control group（ P〈0. 05 / P〈0. 01）; the levels of serum LH and E2 at HCG day and the number of oocytes retrieved were significantly lower than group C（ P〈0. 05）. The pregnancy rate in group B was significant lower compared with group C,as well as the implantation rate（ P〈0. 05）. Conclusion： Women with slow ovarian response during controlled ovarian stimulation have poor IVF outcome,which may be improved by r LH supplementation.

关 键 词：控制性超促排卵 卵巢慢反应 体外受精 重组人黄体生产素 辅助生殖技术 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]