长方案添加重组人黄体生成素对IVF-ET结局的影响  

Influence of adding recombinant human luteinizing hormone on IVF-ET outcome in long protocol

作　　者：农柳莹 谭秀群 NONG Liu-ying;TAN Xiu-qun(Reproductive Medical Center,the Third Affiliated Hospital of Guangxi Medical University,Nanning 530031,China)

机构地区：[1]广西医科大学第三附属医院生殖医疗中心,广西南宁530031

出　　处：《中国当代医药》2018年第24期12-16,共5页China Modern Medicine

基　　金：广西壮族自治区南宁市科学研究与技术开发计划项目(20123139)

摘　　要：目的探讨长方案超促排卵中添加重组人黄体生成素(rh LH)对体外受精-胚胎移植(IVF-ET)结局的影响。方法选取2012年2月~2015年12月在广西医科大学第三附属医院生殖医疗中心行IVF-ET长方案的共538例不孕患者,根据促性腺激素(Gn)启动日血清黄体生成素(LH)水平将患者分为两组,A组:LH<0.5 m IU/ml,共238例,B组:LH≥0.5 m IU/ml,共300例;再根据rh LH添加方案分成以下亚组,A组分为A1组(n=72例,Gn第1天开始添加rh LH)和A2组(n=166例,Gn第8天开始添加rh LH),B组分为B1组(n=137例,单独使用FSH,不添加rh LH)和B2组(n=163例,Gn第8天开始添加rh LH)。比较四组患者的基本情况、实验室数据及临床结局。结果 A1组的Gn天数短于A2组,差异有统计学意义(P<0.05);A1组h CG日血清雌二醇(E2)水平、优质胚胎率、着床率及临床妊娠率均高于A2组,差异有统计学意义(P<0.05)。B2组的Gn用量少于B1组,差异有统计学意义(P<0.05);B1组的正常受精率(2PN)、优质胚胎率、临床妊娠率均高于B2组,差异有统计学意义(P<0.05)。A2组的Gn用量高于B2组,差异有统计学意义(P<0.05),A2组h CG日血E2及LH水平均低于B2组,差异有统计学意义(P<0.05),A2组的临床妊娠率高于B2组,差异有统计学意义(P<0.05)。结论对于长方案中年龄<35岁且Gn启动日血清LH<0.5 m IU/ml的患者,尽早添加rh LH可缩短Gn天数、提高h CG日E2水平,提高优质胚胎率、着床率以及临床妊娠率。对于降调节后血清LH≥0.5 m IU/ml的患者,添加rh LH并不能改善助孕结局。Objective To investigate the influence of adding recombinant human luteinizing hormone（r-h LH） on In vitro fertilization-embryo transfer（IVF-ET） outcome in superovulation of long protocol. Methods A total of 538 infertile patients given long protocol of IVF-ET in Reproductive Medical Center of the Third Affiliated Hospital in Guangxi Medical University from February 2012 to December 2015 were selected. According to their serum LH level on gonadotropin（Gn） initial day, all patients were divided into the two groups： group A（n=238）： LH0.5 m IU/ml and group B（n=300）： LH0.5 m IU/ml, and then according to different methods of adding r-h LH, they were divided into the different subgroups： group A was divided into group A1（n=72, adding r LH from the first day of Gn） and group A2（n=166,adding r LH from the eighth day of Gn. Group B was divided into group B1（n=137, using only FSH, without r-h LH）and group B2（n=163, adding r LH from the eighth day of Gn）. The basic information, main laboratory indexes and clinical outcomes were compared among four groups. Results Compared with group A2, the durations of Gn in group A1 was shorter, and there was a statistical difference（P〈0.05）. The serum E2 level on the day of h CG, high-quality embryo rate, implantation rate and clinical pregnancy rate in group A1 were higher than those in group A2, and there were statistical differences（P〈0.05）. The dosage of Gn in group B2 was fewer than that in group B1, and there was a statistical difference（P〈0.05）. The normal fertilization rate（2 PN）,high-quality embryo rate and clinical pregnancy rate in B1 group were higher than those in group B2, and there were statistical differences（P〈0.05）. The dosage of Gn in group A2 was higher than that in group B2（P〈0.05）, and the E2 level and LH level on h CG day in group A2 were lower than those in group B2, and there were statistical differences（P〈0.05）, and the clinical pregnancy rate in group A2 was significantly higher t

关 键 词：体外受精-胚胎移植 重组人促黄体生成素 控制性超促排卵 妊娠率 

分 类 号：R271.14[医药卫生—中医妇科学]