不同促排卵方案下受精情况及妊娠结局的观察  

Study on fertilization and pregnancy outcome under different ovulation promotion schemes

作　　者：王治鸿[1] 刘翔华[1] 杨盼 曹鹏燕 WANG Zhihong;LIU Xianghua;YANG Pan;CAO Pengyan(Reproduction Center,First Clinical Medical College,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院生殖中心,太原030001

出　　处：《山西医科大学学报》2018年第11期1391-1394,共4页Journal of Shanxi Medical University

基　　金：山西省自然科学基金资助项目(201701D121174)

摘　　要：目的比较不同促排卵方案在首次体外受精-胚胎移植中的应用效果,观察不同方案下的受精情况及临床妊娠结局。方法回顾性分析2015-01~2017-12在我院生殖中心首次接受体外受精/卵母细胞浆内单精子注射治疗的患者,根据促排方案的不同分为4组,分别为长方案组(819例)、短方案组(198例)、拮抗剂方案组(103例)和黄体期促排方案组(34例)。观察获卵情况、受精结果、胚胎发育及临床妊娠结局等。结果黄体期促排方案组的平均年龄[(35. 4±8. 1)岁]高于长方案[(30. 37±4. 27)岁]、短方案[(33. 44±6. 23)岁]、拮抗剂方案[(34. 64±5. 39)岁],差异具有统计学意义(P <0. 05)。长方案组平均获卵数[(16. 08±3. 46)个]高于短方案组[(10. 31±7. 99)个]、拮抗剂方案组[(10. 00±6. 96)个]、黄体期促排方案组[(6. 50±1. 73)个],差异有统计学意义(P <0. 05)。短方案组平均促性腺激素Gn应用时间[(9. 25±2. 99) d]及用量[(32. 52±12. 79) IU]均显著低于长方案组[(11. 59±2. 82) d和(38. 02±14. 74) IU],四组之间的受精率、优质胚胎率差异无统计学意义(P> 0. 05),长方案、短方案及拮抗剂方案组之间的临床妊娠率亦差异无统计学意义(P> 0. 05)。结论长方案、短方案、拮抗剂方案具有相似的受精情况及临床妊娠结局,黄体期促排方案可增加高龄患者取卵次数,增加获卵数及优质胚胎数。Objective To compare the fertilization status and clinical pregnancy outcome of in vitro first fertilization（IVF） under dif- ferent ovulation promotion protocols. Methods The clinical data of patients receiving in vitro fertilization or intraeytoplasmie sperm injeetion（IVF/ICSI） in our reproductive center were retrospectively analyzed. The patients were divided into 4 groups according to the different schemes of promoting ovulation： long regimen group（ n = 819 ）, short regimen group （ n = 198 ）, antagonist group （ n = 103 ） and luteal phase promoting ovulation group（ n = 34 ）. The oviposition, the fertilization result, the embryo development and the clinical pregnancy outcome were observed. Results The average age was higher in luteal phase group [ （35.4±8.1） years ] than in long regimen group [（ 30. 37 ±4. 27 ） years], short regimen group[（ 33.44±6. 23 ） years], and antagonist regimen group [（ 34. 64± 5.39 ） years[ （P 〈 0. 05 ）. The average nmnber of eggs obtainedwas significantly higher in long regimen group （ 16. 08 ± 3.46 ） than in short regimen group （ 10. 31 ±7. 99 ）, antagonist group （ 10. 00±6. 96 ）, and luteal phase drainage promotion group （ 6. 50±1.73, P 〈 0. 05 ）. The average days of gonadotropinl （9. 25±2. 99）dl and the dosage of gonadotropinl （32. 52±12. 79）IUI in short regimen group were significantly lower than those in long regimen group [ 11.59 ±2. 82 ） d and （ 38.02±14. 74 ） IU ] （ P 〉 0. 05 ）. There was no significant difference in clinical pregnancy rate between short regimen group and antagonist group （ P 〉 0. 05 ）. Conclusion Long regimen, short regimen and antagonist regimen have similar fertilization status and clinical pregnancy outcome. Luteal phase ovulation promoting regimen can increase the number of ooeytes fetching in elderly patients, increase the number of acquired eggs and the number of high-quality embryos.

关 键 词：体外受精-胚胎移植 GNRH激动剂 GNRH拮抗剂 黄体期促排 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]