GnRH拮抗剂和GnRH激动剂长方案在35岁以上卵巢正常反应患者的临床效果比较  

Comparison of the effectiveness between gonadotropin-releasing hormone antagonist protocol and gonadotropin-releasing hormone agonist long protocol in patients older than 35 years old with normal ovarian response

作　　者：官文征[1] 王秀霞[1] GUAN Wen-zheng;WANG Xiu-xia(Reproductire Center,Shengjing Hospital of China Medical University,Shenyang 110020,China)

机构地区：[1]中国医科大学附属盛京医院生殖医学一中心,沈阳110020

出　　处：《实用药物与临床》2018年第10期1166-1169,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的比较GnRH拮抗剂方案与GnRH激动剂长方案在35岁以上卵巢正常反应患者行体外受精-胚胎移植(IVF-ET)治疗中的临床疗效。方法将120例高龄(36～45岁)卵巢正常反应患者(共120个超促排卵周期)随机分为GnRH拮抗剂组(拮抗剂组)和GnRH激动剂长方案组(长方案组),行IVF-ET助孕治疗,进行新鲜胚胎移植。比较两组GnRH使用天数、GnRH使用量、获卵数、胚胎数、优质胚胎数、临床妊娠率、胚胎种植率。结果拮抗剂组GnRH使用天数明显短于长方案组(P <0.05);长方案组的Gn平均使用量比拮抗剂方案多,但差异无统计学意义(P> 0.05);两组患者的获卵数、形成胚胎数与移植胚胎数比较,差异无统计学意义(P>0.05);拮抗剂方案获得优质胚胎数多于长方案(P <0.05);拮抗剂方案临床妊娠率、胚胎种植率与长方案比较差异无统计学意义(P> 0.05)。结论 GnRH拮抗剂对35岁以上卵巢正常反应患者,GnRH拮抗剂方案是一种有效的超排卵治疗方案,可以减少超促排卵(COH)时间与费用,可获得质量较好的胚胎。Objective To evaluate the effectiveness of gonadotropin-releasing hormone （GnRH） antagonist protocol and GnRH agonist long protocol in patients older than 35 years old with normal ovarian reserve during IVF-ET. Methods Totally 120 patients of 35 -45 years old with normal ovarian response,including 120 controlled ovarian hyperstimulation （COH） cycles, were divided into GnRH-antagonist protocol group （ antagonist group, n - 59） and GnRtt-agonist long protocol group （ agonist group, n - 61 ）. All the patients received IVF-ET. The duration and dose of GnRH,the number of retrieved oocyte, embryo and qualified embryo,and the rates of clinical pregnancy and implantation were compared between the two groups. Results The duration of GnRH in antagonist group was shorter than that in agonist group （P 〈 0. 05） ;the dose of GnRH in antagonist group was slightly less than that in agonist group （P 〉 0. 05）. There was no significant difference in the number of retrieved oocytes, embryo and the transferred embryo be- tween the two groups （P 〉 0. 05 ） , however, the number of qualified embryo in antagonist group was higher （P 〈 0.05 ）. The clinical pregnancy rate and the implantation rate were similar in both groups （ P 〉 0.05 ）. Conclusion The GnRH-antagonist protocol appears to be effective in patients over 35 years old, which can reduce the usage and expense of COH,and improve the quality of embryos.

关 键 词：GNRH 拮抗剂 激动剂 长方案 高龄 卵巢正常反应 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]