低促性腺激素性性功能不全妇女IVF-ET治疗中的方法及疗效分析  

Efficacy of in vitro fertilization and embryo transfer of women with hypogonadotropic hypogonadism

作　　者：王含必[1] 温晓晓[2] 汤鲜[3] 周远征[1] 孙正怡[1] 甄璟然[1] 刘美芝[1] 王雪[1] 张颖[1] 邓成艳[1] 

机构地区：[1]北京协和医院妇产科,100730 [2]甘肃省妇幼保健院 [3]湖南省娄底市中心医院生殖中心

出　　处：《中国计划生育学杂志》2017年第5期318-322,327,共6页Chinese Journal of Family Planning

摘　　要：目的:分析低促性腺激素性性功能不全(HH)患者体外受精-胚胎移植(IVF-ET)的治疗方法及疗效分析。方法:回顾性分析了接受IVF-ET治疗的40例HH患者共60个IVF-ET周期,收集同期因输卵管因素和/或男方因素接受IVF-ET治疗的134例患者共140个周期的病历资料作为对照组。对这两组患者进行回顾性分析,对治疗方法、临床结局进行分析总结。将HH患者分成妊娠组与未妊娠组,比较各组间差异。结果:经控制性超促排卵(COH)治疗后,发现卵泡刺激素(FSH)和黄体生成素(LH)的使用量及使用天数HH组都明显高于对照组(FSH:55.0±2.5支vs 36.9±1.0支;LH:28.3±1.7支vs 5.9±0.2支;治疗天数:13.8±0.4dvs 10.4±0.1d;P均<0.05)。治疗后卵泡刺激素(FSH)、雌激素(E2)、孕酮(P)的水平无统计学差异。获卵数、优胚数及冻胚数等无统计学差异,妊娠结局在两组间也无统计学差异(妊娠率:42.1%vs 53.6%;流产率:16.7%vs 26.7%)。HH患者中比较妊娠与未妊娠后发现在年龄、体重指数和药物使用剂量及天数方面无明显差异,而妊娠组获卵数(6.6±0.5个vs 8.8±0.7个)、成熟卵母细胞(MII)数(5.5±0.5个vs 7.3±0.7个)及受精率(4.9±0.5%vs 6.7±0.7%)妊娠组低于未妊娠组,有统计学差异。结论:HH患者处于长时间促性腺激素缺乏状态,IVF-ET的治疗过程中药物使用剂量更多、时间更长,但妊娠结局与正常女性相似。Objective：The aim of this study was to evaluate the effect of patients with hypogonadotropic hypogonadism （HH） who undergone in-vitro fertilization and embryo transfer （IVF-ET）.Methods：A retrospective cohort study was conducted,and 40 women with HH （60 IVF ET cycles） were in HH group,134 women with tubal factor （TF） or male factor （MF） infertility （140 IVF-ET cycle） who underwent IVF-ET were in control group.Women in HH group were divided into two subgroups according to pregnant outcomes.Results：After treatment by controlled ovarian hyperstimulation （COH）,dose and time of Follicle-Stimulating Hormone （FSH） and Luteinizing Hormone （LH） used of women in HH group were significant higher than those of women in control group（FSH：55.0±2.5 vs 36.9±1.0 ampuls;LH：28.3±1.7vs.5.9±0.2 ampuls;duration：13.8±0.4 days vs.10.4±0.1 days;P〈0.05）.There was no significant different in level of FSH,estrogen （E2） and progesterone （P） of women after treatment between the two groups.The mean number of retrieved oocytes,high qualified embryo and frozen embryos had no significant different between the two groups.There were no significant difference in pregnant rate （42.1 vs.53.6%,P〉0.05） and rate of abortion （16.7 vs.26.7%,P〉0.05） between the two groups.As for women in the two HH subgroups,there were no significant difference in age,body mass index （BMI）,duration of stimulation and gonadotropin dose,but number of retrievedoocytes（6.6±0.5 vs.8.8±0.7,P〈0.05）,number of MII （5.5±0.5 vs.7.3±0.7,P〈0.05）and rate of fertilization（4.9±0.5 vs.6.7 ± 0.7,P〈0.05） of women in non-pregnancy subgroup were significant lower when compared to those of women in pregnancy subgroup.Conclusion：Patients with HH are in long-term gonadotropin deficiency,so the duration of stimulation for them should be longer and the total gonadotropin dose using should be high-er when IVF-ET.However,the pregnant outcomes of patients with HH were same as those of normal wom

关 键 词：低促性腺激素性闭经 IVF-ET 排卵 诱导 妊娠 

分 类 号：R714.8[医药卫生—妇产科学]