减量降调长方案与拮抗剂方案在卵巢储备功能低下患者中的临床疗效观察  

Clinical effect of reduced dose gonadotropin releasing hormone agonist long protocol and gonadotropin releasing hormone antagonist protocol in patients with decreased ovarian reserve

作　　者：席思思[1] 杨慕坤[1] 曾诚[1] 徐阳[1] 尚鶄[1] 薛晴[1] XI Si-si;YANG Mu-kun;ZENG Cheng;XU Yang;SHANG Qing;XUE Qing(Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中国实用妇科与产科杂志》2018年第5期559-562,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨卵巢储备功能低下患者接受减量降调长方案与拮抗剂方案辅助生殖技术的临床疗效。方法回顾分析2012年1月至2016年4月于北京大学第一医院生殖中心接受体外受精-胚胎移植(IVF-ET)、单精子卵胞浆内注射(ICSI)辅助生殖技术治疗的卵巢储备功能低下患者,其中接受减量降调长方案治疗病例84个周期及接受拮抗剂方案治疗病例84个周期,比较两组的妊娠结局。结果减量降调长方案组获卵数(5.6个)、受精数(3.7个)、成胚数(3.8个)、可移植胚胎数(3.3个)显著高于拮抗剂组(3.3个,2.4个,2.4个,2.1个,P均<0.01)。拮抗剂组促性腺激素(Gn)用量及时间少于减量降调长方案组(2591.1U vs.3402.7U,8.3d vs.11.3d,P值均<0.01)。两组鲜胚移植周期的种植率、临床妊娠率、流产率、异位妊娠率未见明显差异,每取卵周期累计临床妊娠率未见明显差异。结论拮抗剂方案的Gn用量少,而减量降调长方案获卵数、可移植胚胎数更多。Objective To compare the clinical effect of reduced dose gonadotropin releasing hormone（GnRH）agonist long protocol with that of GnRH antagonist protocol in patients with decreased ovarian reserve in IVF/ICSI cycles.Methods From January 2012 to April 2016,women with decreased ovarian reserve receiving IVF-ET and ICSI in Peking University First Hospital Reproductive Center clinic were included in this study. A total of 84 cycles received controlled ovarian stimulation by using reduced dose GnRH agonist long protocol and another 84 cycles by GnRH antagonist protocol.The pregnant outcomes between the two groups were compared.Results The numbers of oocytes,fertilization embryo,embryo and transferable embryo were significantly higher in reduced dose GnRH agonist long protocol group（5.6 vs. 3.3,3.7 vs. 2.4,3.8 vs. 2.4,3.3 vs. 2.1,P0.01）. The usage of gonadotropins and duration of controlled ovarian stimulation in GnRH antagonist protocol group were significantly less than that in reduced dose GnRH agonist long protocol group（2591.1 U vs. 3402.7 U,8.3 d vs. 11.3 d,P0.01）. No significant difference was found in implantation rate,clinical pregnancy rate,abortion rate or ectopic pregnancy rate of each fresh embryo transfer cycle between the 2 groups. No significant difference was found in cumulative clinical pregnancy rate of each oocyte retrieval cycle between the 2 groups.Conclusion The advantage of GnRH antagonist protocol is less dosage of gonadotropin. The number of oocyte retrieved and transferable embryo number in reduced dose long protocol are more.

关 键 词：卵巢储备功能低下 减量降调长方案 拮抗剂方案 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]