长效长方案超促排卵中晚期添加黄体生成素对体外受精-胚胎移植结局的影响  

Effect of luteinizing hormone supplementation in middle or late follicle phase on the outcome of in vitro fertilization-embryo transfer of long protocol controlled ovarian hyperstimulation

作　　者：杨军[1] 吴淑卿[1] 

机构地区：[1]汕头市中心医院生殖中心,515031

出　　处：《国际医药卫生导报》2016年第19期2929-2933,共5页International Medicine and Health Guidance News

摘　　要：目的 探讨长效长方案控制性超促排卵过程中添加黄体生成素（LH）对体外受精-胚胎移植（IVF-ET）结局的影响.方法 回顾性分析在本院生殖中心接受IVF-ET治疗的120例不孕患者的临床资料,研究对象均于月经第3-5 d行人绝经期促性腺激素（HMG）促超排卵,当卵泡最大直径达14 mm时,按当日黄体生成素（LH）水平分为三组,每组40个周期,1组：LH＜1 mIU/ml;2组：1 mIU/ml≤LH＜2mIU/ml;3组：LH≥2 mIU/ml.每组再分为A组（20周期）：继续使用HMG至HCG注射日;B组（20周期）每天添加重组黄体生成素（r-LH）.比较各组的临床结局.结果 A1组促性腺激素（Gn）用量、Gn时间、流产率显著高于B1组,妊娠率显著低于B1组,差异有统计学意义（P＜0.05）;两组间添加LH日及HCG日血清LH水平、获卵数、受精率比较差异均无统计学意义（P＞0.05）.A2组妊娠率显著低于B2组,Gn用量、Gn时间、获卵数、受精率、流产率、添加LH日及HCG日血清LH水平比较差异均无统计学意义（P＞0.05）.A3、B3组间各项指标比较差异均无统计学意义（P＞0.05）.结论 长效长方案卵泡中晚期在LH＜2 mIU/ml时添加LH可提高妊娠率,尤其血清LH＜1 mIU/ml时添加LH可获较好的临床结局,LH＞2 mIU/ml时不能从添加LH中获益.Objective To explore the effect of luteinizing hormone （LH） supplementation on the outcome of in vitro fertilization-embryo transfer （IVF-ET） of long protocol controlled ovarian hyperstimulation （COH）.Methods The clinical data of 120 IVF-ET cycles in center of clinical reproductive medicine of our hospital was analyzed retrospectively.All cases underwent long protocol down regulation with gonadotropin releasing hormone agonis （GnRH-a） in the mid-luteal phase,and controlled ovarian stimulation （COS） was carried out with HMG on the 3rd-5th day of the menstrual cycle.When a dominant follicle reached a diameter of 14 mm,all cases were divided into 3 groups according to the LH level：group one （40 cycles）,LH 〈 1 mlU/ml;group two （40 cycles）,1 mlU/ml ≤ LH 〈 2 mIU/ml;group three （40 cycles）,LH ≥ 2 mlU/ml.According to the project of LH supplementation,each group were sub-divided into 2 subgroups：group A （20 cycles）,without supplementation of r-LH;group B （20 cycles）,with supplementation of r-LH.Clinical outcome of all groups were analyzed and compared.Results The duration and dose of gonadotropin （Gn） and abortion rate in group A 1 were higher than those in group B1,the rate of pregnancy was lower （P〈0.05）.There were no statistically significant differences in serum LH concentration,the number of retrieved oocytes,the rate of fertilization on the day of r-LH and HCG administration between group A1 and group B1 （P〉0.05）.The rate of pregnancy in group A2 was significantly lower than that in group B2 （P〈0.05）.There were no statistically significant differences in the duration and dose of Gn,the number of retrieved oocytes,the rate of fertilization,abortion rate,serum LH concentration on the day ofr-LH and HCG administration between group A2 and group B2 （P〉0.05）.There were no statistically significant differences in each indicator between group A3 and group B3 （P〉0.05）.Conclusions When serum LH level was lower than 2 mIU/ml,especially lower

关 键 词：体外受精-胚胎移植 长方案 超促排卵 重组黄体生成素 人绝经期促性腺激素 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]