避孕药与促性腺激素释放激素激动剂对子宫内膜异位症患者体外受精助孕前预治疗的疗效分析  

Analysis on curative effect of contraceptive drugs and gonadotropin-releasing hormone agonist in pretreatment of in vitro fertilization of patients with endometriosis

作　　者：周晓燕[1] 

机构地区：[1]皖北煤电集团总医院生殖医学科,安徽宿州234000

出　　处：《中国妇幼保健》2016年第20期4241-4243,共3页Maternal and Child Health Care of China

摘　　要：目的比较子宫内膜异位症（EMs）不孕症患者行体外受精-胚胎移植（IVF-ET）助孕前用促性腺激素释放激素激动剂（GnRHa）与避孕药（Oc）预治疗组的临床效果。方法 EMs患者56个周期,分为GnRHa预治疗组的35个周期与Oc预治疗组的21个周期;选取同期单纯输卵管性不孕患者49个周期为对照组。比较Ems患者不同药物预治疗后获卵数、受精率、卵裂率、优质胚胎数及临床妊娠率。结果 EMs患者GnRHa预治疗组降调后黄体生成激素（LH）、雌二醇（E2）水平低,人绒毛膜促性腺激素（hCG）日E2值、获卵数及优质胚胎数最低,与对照组比较差异有统计学意义（F值分别为12.288、6.402、7.43、12.461和9.43,均P〈0.05）;Gn天数及Gn用量高于对照组,差异有统计学意义（F值分别为12.184、8.64,均P〈0.05）。与GnRHa预治疗组比较,Oc预治疗组hCG日E_2值高及获卵数多,差异有统计学意义（F值分别为8.52、5.58,均P〈0.05）。各组受精率、卵裂率、临床妊娠率差异无统计学意义（χ^2值分别为0.07、0.36和0.09,均P〉0.05）。结论 EMs患者经GnRHa或Oc预治疗后都能获得相似的受精率、卵裂率和临床妊娠率,但Oc预治疗疗效肯定、不良反应轻微、价格低廉,成本效益优势明显,值得推广。Objective To compare the clinical effects of gonadotropin-releasing hormone agonist（ GnRHa） and contraceptive drugs in pretreatment of in vitro fertilization-embryo transfer（ IVF-ET） of patients with endometriosis. Methods Fifty-six cycles of patients with endometriosis were divided into GnRHa pretreatment group（ 35 cycles） and contraceptive drug pretreatment group（ 21 cycles）. Forty-nine cycles of patients with tubal infertility during the same period were selected as control group. The numbers of oocytes retrieved,fertilization rates,cleavage rates,the numbers of high quality embryos,and clinical pregnancy rates in different groups were compared. Results After down-regulation in GnRHa pretreatment group,the levels of luteinizing hormone（ LH） and estradiol,the level of estradiol on the day of human chorionic gonadotropin（ hCG） injection,the number of oocytes retrieved,and the number of high quality embryos were the lowest,compared with control group,there were statistically significant differences（ F = 12. 288,6. 402,7. 43,12. 461,9. 43,P〈0. 05）; the time and dose of gonadotrophin（ Gn） were statistically significantly higher than those in control group（ F = 12. 184,8. 64,P〈0. 05）. Compared with GnRHa pretreatment group,the level of estradiol on the day of hCG injection and the number of oocytes retrieved were higher,there were statistically significant differences（ F = 8. 52,5. 58,P〈0. 05）. There was no statistically significant difference in fertilization rate,cleavage rate,and clinical pregnancy rate among the three groups（ χ^2= 0. 07,0. 36,0. 09,P〉0. 05）. Conclusion The fertilization rates,cleavage rates,and clinical pregnancy rates of GnRHa and contraceptive drugs in pretreatment of IVF-ET of patients with endometriosis are similar,but contraceptive drugs have the advantages of good effect,minimal adverse reactions,and low cost,which is worthy of clinical promotion.

关 键 词：子宫内膜异位症 促性腺激素释放激素激动剂 避孕药 体外受精-胚胎移植 

分 类 号：R711.71[医药卫生—妇产科学]