灵活剂量促性腺激素释放激素拮抗剂治疗多囊卵巢综合征临床效果观察  

Observation on the clinical effect of flexible-dose gonadotrophin-releasing hormone antagonist in treatment of polycystic ovary syndrome

作　　者：杜惠[1] 印惠荣[1] 张文静[1] 白雪梅[1] 刘敏[1] 冯书改[1] 朱旻[1] 松迪[1] 张慧琴[1] 

机构地区：[1]第二军医大学长海医院生殖医学中心,上海200433

出　　处：《中国妇幼保健》2017年第17期4209-4211,共3页Maternal and Child Health Care of China

摘　　要：目的评估灵活剂量促性腺激素释放激素拮抗剂(GnRH-A)方案和标准半量的GnRH-A方案在多囊卵巢综合征(PCOS)患者微刺激周期进行体外受精-胚胎移植(IVF-ET)/卵细胞浆内单精子注射(ICSI)的超促排卵过程中的应用价值。方法回顾性分析88例PCOS患者采用克罗米芬微刺激方案联合使用GnRH-A进行IVF-ET助孕,其中46例使用灵活剂量GnRH-A方案(A组),42例使用标准半量GnRH-A方案(B组)。比较各组实验室指标和临床结局。结果与B组比较,A组人绒毛膜促性腺激素(h CG)日促黄体生成素(LH)、孕酮(P)水平明显降低,受精率、卵裂率、优质胚胎率、新鲜胚胎移植周期临床妊娠率显著升高,差异有统计学意义(P<0.05);Gn天数、Gn用量、内膜厚度、获卵数、成熟卵数及新鲜胚胎移植周期移植胚胎数组间无统计学差异(P>0.05)。结论与标准半量GnRH-A方案相比,灵活的GnRH-A联合微刺激方案可获得更多的优质胚胎,提高临床妊娠率和胚胎着床率。Objective To evaluate the application value of flexible-dose gonadotrophin-releasing hormone antagonist （GnRH-A） protocol and standard half-dose GnRH-A protocol in patients with polycystic ovary syndrome （PCOS） undergoing controlled ovarian hyperstimulation （COH） for in vitro fertilization-embryo transfer （IVF-ET） /intracytoplasmic sperm injection （ICSI）.Methods Eighty-eight patients receiving clomifen micro-stimulation protocol combined with GnRH-A for IVF-ET were analyzed retrospectively,including 46 patients treated by flexible-dose GnRH-A protocol （group A） and 42 patients treated by standard half-dose GnRH-A protocol （group B）.The laboratory indexes and clinical outcomes were compared between the two groups.Results Compared with group B,the levels of luteinizing hormone （LH） and progesterone （P） on the day of human chorionic gonadotropin （hCG） injection in group A decreased significantly,while the fertilization rate,cleavage rate,high-quality embryo rate,clinical pregnancy rate per fresh embryo transfer cycle in group A increased significantly,there were statistically significant differences （P〈0.05）.There was no statistically significant difference in the application time and dosage of Gn,endometrial thickness,the number of oocytes retrieved,the number of mature oocytes,and the number of transferred embryos in fresh ET cycle between the two groups （P 〉 0.05）.Conclusion Compared with standard half-dose GnRH-A protocol,flexible-dose GnRH-A protocol can obtain more high-quality embryos,improve clinical pregnancy rate and implantation rate.

关 键 词：多囊卵巢综合征 微刺激方案 促性腺激素释放激素拮抗剂 临床妊娠率 

分 类 号：R711.75[医药卫生—妇产科学]