低剂量人绒毛膜促性腺激素对卵巢过度刺激综合征高危患者体外受精-胚胎移植临床结局的影响  

Effect of low-dose of human chorionic gonadotropin(hCG) on clinical outcomes of the patients with high risk of ovarian hyperstimulation syndrome(OHSS) during in vitro fertilization-embryo transfer(IVF-ET)

作　　者：陈雅[1] 林金菊[1] 

机构地区：[1]温州医科大学附属第一医院生殖中心

出　　处：《中国临床药理学与治疗学》2016年第7期811-815,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨体外受精-胚胎移植(IVF-ET)中低剂量人绒毛膜促性腺激素(h CG)对卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)高危患者临床结局的影响及h CG促卵子成熟的最低有效剂量。方法:回顾性分析2010年12月至2014年6月行IVF/ICSI的h CG注射日血E2≥15 000 pmol/L的OHSS高危患者591例,根据h CG注射剂量分:2 000 IU(A组35例),3 000 IU(B组76例),4 000 IU(C组137例)和5000 IU(D组343例),比较各组的促排卵结果和妊娠结局。结果:C组(21.55±7.57)个获卵数显著高于A组的(18.00±5.70)个、B组的(18.00±5.50)个及D组的(19.30±6.45)个(P<0.05),受精率(75.86%)高于A组(70.97%)和B组(70.18%,P<0.05),种植率(49.03%)明显高于A组(26.09%),且差异有统计学意义(P<0.05);但成熟率低于B组与D组(P<0.05)。B组受精率明显低于D组(P<0.01)。四组两两相比,临床妊娠率和抱婴回家率及中重度OHSS发生率均无统计学差异(P>0.05)。结论:低剂量h CG不影响OHSS高危患者IVF-ET妊娠结局,h CG 3 000或4 000 IU不但能促卵子成熟且不影响胚胎发育潜能而且能有效降低中重度OHSS的发生率。AIM： To investigate the effect of low-dose of human chorionic gonadotropin （hCG） on clinical results of the women with high risk of ovari- an hyperstimulation syndrome（OHSS） during in vitro fertilization-embryo transfer（IVF-ET） and the subop- timal dose of hCG used for inducing oocyte matura- tion. METHODS： Retrospective evaluation of five hundred and ninty one women who had high risks of OHSS because of serum estradiol level higher than 15 000 pmol/L on hCG injection day accepted IVF- ET treatment during the period from December 2010 to June 2014. All cases were divided into four groups according to the trigger dose of hCG： 2 000 IU（group A,n =35）, 3 000 IU（group B, n =76）, 4 000 IU（group C, n = 137） , 5 000 IU（group D,n = 343）. The clinical outcomes were analyzed. RESULTS：In group C, eggs retrieved（21.55±7.57） were more than those of group A, B and D signifi- cantly（ 18.00± 5.70, 18.00± 5.50 and 19.30±6.45 respectively, P 〈 0.05 ） ; the fertilization rate （75. 86%） was higher than those of group A （70.97%） and B（70.18%, P 〈0.05） ; and the rate of embryo implantation （49.03%） was signifi- cantly higher than group A（26.09% ） ; but the rate of oocytes maturation was lower, compared with group B and D （ P 〈 0.05 ）. And the fertilization rate of group B was significantly lower than that of group D （P 〈 0.01 ）. No statistically differences were found in the rates of clinical pregnancy, baby take home and moderate or serious OHSS among group A, B, C and D （ P 〉 0.05 ）. CONCLUSION ： Low dosage of hCG can not affect the clinical pregnancy results of patients who had high risk of OHSS, and the hCG dose of 3 000 IU or 4 000 IU may be the lowest and most valid in inducing oocyte maturation without adversely affecting embryos＇development potency subsequently and reduces the occurrence risk of moderate or severe OHSS effectively. KEYWORDS human chorionic gonadotropin; in vitro fertilization-embryo transfer; ovarian hyperstimulation

关 键 词：人绒毛膜促性腺激素 体外受精-胚胎移植 卵巢过度刺激综合症 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学]