HMG预处理在长效长方案降调节中的应用  

HMG preprocess application in long-acting protocol

作　　者：戴芳芳 郑波 郭影 许晓立 郭钰英 李慧 

机构地区：[1]河北省邢台不孕不育专科医院生殖中心,邢台054001

出　　处：《生殖医学杂志》2017年第10期1011-1015,共5页Journal of Reproductive Medicine

摘　　要：目的探讨人绝经期促性腺激素(HMG)预处理在长效长方案降调节中的应用价值。方法收集2014年1月至2016年6月在本院生殖医学中心采用长效达菲林长方案治疗的IVF-ET患者共254例。按照随机数字表随机分为预处理组(118例)和非预处理组(136例),预处理组促排卵前给予HMG 75U肌肉注射预处理4d。比较两组患者促排卵各项指标及妊娠结局。结果两组患者一般资料比较无显著性差异(P>0.05)。预处理组Gn天数、Gn使用总量显著低于非预处理组(P<0.05);预处理组HCG日孕酮(P)值、HCG日E2值略低于非预处理组,获卵数略少于非预处理组,MⅡ卵数、MⅡ卵率、可用胚胎数及临床妊娠率略高于非预处理组,中度及以上OHSS发生率略低于非预处理组,但均无显著性差异(P>0.05);预处理组预处理后FSH水平显著高于预处理前及非预处理组,卵泡直径显著大于预处理前及非预处理组(P均<0.05)。结论长效长方案降调节后促排卵前应用HMG预处理可以减少Gn用量、Gn天数,且妊娠率有增高的趋势、OHSS发生率有降低的趋势,提示短时间的HMG预处理可能有利于妊娠结局。Objective: To investigate the value of HMG pretreatment in long-acting & long-term protocol of IVF-ET.Methods: A total of 254IVF-ET patients with adopting long-term triptorelin acetate(Diphereline)in long protocol in Xingtai Infertility Specialist Hospital from June 2014 to June 2016 were collected.The patients were randomly divided into pretreatment group(118cases)and non-pretreatment group(136cases)according to the random number table.The patients in pretreatment group were given HMG 75 Ui.m.for 4days before ovulation induction.The indicators of ovulation induction and pregnancy outcomes were compared between the two groups.Results: There was no significant difference in basic condition between the two groups(P>0.05).The days and total dosage of Gn used in pretreatment group were significantly less than those in non-pretreatment group(P<0.05).The levels of progesterone and E2 on HCG day,the number of oocytes retrieved and the OHSS incidence were lower than non-pretreatment group,while the number of MII oocytes and the MII oocyte rate,the number of available embryos and clinical pregnancy rate were higher than non-pretreatment group,but there were no significant differences(all P>0.05).The FSH levels in the pretreatment group were significantly higher,and the follicle diameter was significantly larger than before pretreatment and the non-pretreatment group(all P<0.05).Conclusions: HMG pretreatment after long-acting & long-term protocol and before ovulationinduction can reduce the dosage and days of Gn used,as well as slightly improve pregnancy rate and reduce the incidence of OHSS.It suggests that short-term HMG pretreatment may be beneficial to pregnancy outcomes.

关 键 词：人绝经期促性腺激素 促性腺激素释放激素激动剂 黄体生成素 体外受精-胚胎移植 

分 类 号：R[医药卫生]