控制性超促排卵时未添加拮抗剂患者的临床结局分析  

Clinical analysis on patients without gonadotrophin-releasing hormone antagonist suppression in controlled ovarian hyperstimulation

作　　者：徐红妹 刘芸[1] 黄吴键[1] 毛丽华 王彩霞 王锦华 何凌云[1] Xu Hongmei;Liu Yun;Huang Wujian;Mao Lihua;Wang Caixia;Wang Jinhua;He Lingyun(Center for Reproductive Medicine, Fuzhou General Hospital, Fuzhou 350025, Chin)

机构地区：[1]福州总医院生殖医学中心,福建医科大学福总临床学院生殖医学中心,350025

出　　处：《中华生殖与避孕杂志》2018年第3期215-218,共4页Chinese Journal of Reproduction and Contraception

基　　金：福建省自然科学基金资助项目(2016J01589)

摘　　要：目的分析探讨促性腺激素释放激素(Gn RH)拮抗剂方案中不需要添加拮抗剂患者的相关因素及其促排卵结局。方法回顾性队列研究本院生殖医学中心2015年3月—2016年9月期间行GnRH拮抗剂方案超促排卵中未添加拮抗剂的141例患者(A组)及添加拮抗剂的282例患者(B组)的治疗过程中的激素变化及促排卵结局。结果刺激周期中雌二醇(E_2)以及孕酮(P)水平差异均无统计学意义。A组患者促性腺激素(Gn)第6日黄体生成素(LH)水平[(1.97±1.81)IU/L]显著低于B组患者[(4.08±5.37)IU/L,P<0.001),A组Gn第6日直径<11 mm的卵泡数(14.7±10.4)显著高于B组(12.0±8.9,P=0.004);A组Gn第8日LH水平[(2.48±1.61)IU/L]显著低于B组患者[(4.04±3.45)IU/L,P<0.001],Gn第8日A组直径<11 mm的卵泡数(7.1±8.9)也显著高于B组(4.9±6.3,P=0.008)。获卵数、成熟卵子数、双原核(2PN)受精数、优质胚胎数以及形成优质囊胚数差异均无统计学意义(P>0.05)。结论在拮抗剂方案超促排卵过程中,部分患者即使不添加拮抗剂也不会出现LH峰或提前排卵,且这部分患者与常规添加拮抗剂患者相比能获得相似的促排卵结局。Objective To explore related factors in patients without routine pituitary suppression in gonadotrophin-releasing hormone antagonist （GnRH-A） protocol and the clinical outcomes. Methods A retrospective cohort study of hormone changes and clinical outcomes in patients with in vitro fertilization （IVF） cycles were performed at Reproductive Medicine Centre, Fuzhou General Hospital from March 2015 to September 2016, including group A （141 patients without GnRI-I-A） and group B （282 patients with GnRH-A）. Results No significant differences were found in terms of the level of estradiol （E2） or progesterone （P） between group A and group B. The level of luteinizing hormone （LH） in group A [（1.97±1.81） IU/L] was significantly lower than that in group B [（4.08±5.37） IU/L, P〈0.001] on day 6 of gonadotrophin （Gn） stimulation, and the number of follicles which diameter 〈 11 mm in group A （14.7±10.4） was significantly more than that in group B on this day （12.0±8.9, P=0.004）. Similarly, the level of LH in group A [（2.48±1.61） IU/L] was significantly lower than that in group B on day 8 of Gn stimulation [（4.04±3.45） IU/L, P〈0.001], and the number of follicles which diameter 〈 11 mm in group A （7.1±8.9） was significantly more than that in group B on this day （4.9±6.3, P=0.008）. No significant differences were found in terms of the number of oocytes retrieved, number of mature oocytes, number of 2 pronuclear （PN） fertilization, number of high-quality embryos and high-quality blastocysts. Conclusion Similar clinical outcomes were required in patients without routine pituitary suppression in GnRH-A protocol with no occurrence of LH in these patients.

关 键 词：拮抗剂方案 黄体生成素(LH)峰 控制性超促排卵(COH) 

分 类 号：R714.8[医药卫生—妇产科学]