卵巢低反应高龄患者体外受精-胚胎移植的不同促排卵方案比较  

Analysis of different ovarian stimulation protocols for IVF-ET to infertile aged women with poor ovarian response

作　　者：李颖[1] 兰永连[1] 梁毓[1] 周丽颖[1] 雷玲玲[1] 张军[1] 王树玉[1] 

机构地区：[1]首都医科大学附属北京妇产医院生殖医学科,北京100026

出　　处：《中国优生与遗传杂志》2018年第2期88-90,111,共4页Chinese Journal of Birth Health & Heredity

基　　金：国家自然科学基金项目(81601341)

摘　　要：目的比较不同控制性超促排卵方案在卵巢低反应、高龄(年龄≥40岁)患者体外受精-胚胎移植中的应用效果。方法回顾性分析2015年10月~2016年10月于首都医科大学附属北京妇产医院生殖医学科行IVF-ET治疗,以GnRH-a短方案、GnRH-A拮抗剂方案和微刺激方案促排卵,年龄≥40岁的卵巢低反应病例148例,比较各组实验室及临床资料。结果 3组不同促排卵方案患者的一般情况、成熟卵率、正常受精率、优质胚胎率、胚胎种植率和临床妊娠率差异均无统计学意义(P>0.05)。短方案组(4.21±2.15)和微刺激方案组(3.07±1.78)的获卵数均低于拮抗剂方案组(5.18±2.76);微刺激方案组的Gn用量、Gn使用天数、内膜厚度、可利用胚胎数均低于短方案组和拮抗剂组,差异有统计学意义(P<0.05)。结论对于高龄的POR患者,3种方案有相近的临床结局,微刺激方案Gn用量少、用药时间短,降低成本,但移植取消率较高。Objective：To compare the effects of different ovarian stimulation protocols in poor ovarian response patients aged 40 or elder in vitro fertilization-embryo transfer. Methods：A total of 148 patients were undergoing IVF-ET,with different methods including short GnRH agonist and antagonist protocols,micro stimulation protocol in controlled ovarian hyperstimulation between October 2015 and October 2016 in Beijing Obstetrics and Gynecology Hospital,Capital Medical University. They were divided into three groups according to the different ovarian stimulation protocols,and the clinical data and outcomes were compared between three groups. Results：There was no statistical difference in general characteristics,mature follicle rate,fertilization rate,the rate of high quality embryo,implantation rate,and clinical pregnancy rate（P0.05）. But the duration and dosage of gonadotropin（Gn）,endometrial thickness,the number of available embryo in micro-stimulation protocol group differed significantly comparing with the other two groups（P0.05）. And GnRH antagonist group got more oocytes retrieved than the other two groups（P0.05）. Conclusion：Compared with GnRH agonist and antagonist protocols,micro-stimulation protocol reduces Gn dosage,which seems to be a economic and effective choice for aged women with poor ovarian response.

关 键 词：卵巢低反应 高龄 体外受精-胚胎移植 超促排卵 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]