激动剂超短方案与拮抗剂方案在高龄患者体外受精-胚胎移植中的比较  

Comparison of agonist ultra-short protocol and antagonist protocol in in vitro fertilization-embryo transfer among older patients

作　　者：王涛 师娟子[1] 安瑞芳 刘珊[1] WANG Tao;Sill Juan-Zi;AN Rui-Fang;et al(Northwest Women ＆ Children＇s Hospital, Xi＇an, Shaanxi 710061, China)

机构地区：[1]西北妇女儿童医院,陕西西安710061 [2]西安交通大学第一附属医院妇产科,陕西西安710061

出　　处：《中国妇幼保健》2017年第24期6244-6246,共3页Maternal and Child Health Care of China

摘　　要：目的比较体外受精-胚胎移植(IVF-ET)中≥40岁患者激动剂超短方案与拮抗剂方案的结局。方法回顾性分析年龄≥40岁、行激动剂超短方案或拮抗剂方案的获卵周期数共405周期,按照方案分为两组:A组为激动剂超短方案,B组为拮抗剂方案,分析两组间以下参数的差异:周期数、年龄、不孕年限、基础促卵泡素(b FSH)、基础窦卵泡数(AFC)、Gn刺激天数、Gn用量、移植日内膜厚度、HCG日E_2值、受精数(率)、优胚数(率)、囊胚形成率、平均移植胚胎数、种植率、临床妊娠率、早期流产率、无可移植胚胎率。结果两组患者平均年龄、不孕年限、b FSH、AFC、移植日内膜厚度、移植胚胎数差异无统计学意义(P>0.05)。A组患者Gn用量、Gn天数及HCG日E_2值、获卵数显著高于B组患者,差异有统计学意义(P<0.05)。2PN率、优胚率、囊胚形成率两组间差异无统计学意义(P>0.05),但A组种植率显著高于B组,差异有统计学意义(P<0.05)。两组间虽然临床妊娠率无差异,但A组有升高趋势,且A组无可移植胚胎率显著低于B组,两组早期流产率差异无统计学意义(P>0.05)。结论激动剂超短方案对高龄患者较拮抗剂方案能够获得更好的结局。Objective To compare the outcomes of ultra-short protocol and antagonist protocol in in vitro fertilization-embryo transfer （IVF-ET） among patients ≥40 years old.Methods A total of 405 retrieval cycles of agonist ultra-short protocol and antagonist protocol in patients≥40 years old was analyzed,then they were divided into group A （agonist ultra-short protocol） and group B （antagonist protocol）.The parameters compared between the two groups included the number of cycles,age,years of infertility,basic follicle stimulating hormone （bFSH） level,basic antral follicle count （AFC）,the application time and dose of gonadotropin （Gn）,endometrial thickness on the day of ET,estradiol （E2） level on the day of human chorionic gonadotrophin （hCG） injection,fertilization rate,high-quality embryo rate,blastocyst formation rate,the average number of transferred embryos,implantation rate,clinical pregnancy rate,early abortion rate,and the rate of non-transferred embryo.Results There was no statistically significant difference in average age,years of infertility,bFSH,AFC,endometrial thickness on the day of ET,and the average number of transferred embryos between the two groups （P〉0.05） The application time and dose of Gn,E2 level on the day of hCG injection,and the number of retrieved oocytes in group A were statistically significantly higher than those in group B （P〈0.05）.There was no statistically significant difference in 2PN rate,high-quality embryo rate,and blastocyst formation rate between the two groups （P〉0.05）.The implantation rate in group A was statistically significantly higher than that in group B s （P〈0.05）.There was no statistically significant difference in clinical pregnancy rate between the two groups,but the clinical pregnancy rate in group A was higher than that in group B.The rate of non-transferred embryo in group A was significantly lower than that in group B.There was no statistically significant difference in early abortion rate between the two grou

关 键 词：体外受精-胚胎移植 高龄 激动剂超短方案 拮抗剂方案 

分 类 号：R711.6[医药卫生—妇产科学]