重组人生长激素在首次早卵泡期长效长方案治疗失败患者再次助孕中的应用  

Application of recombinant human growth hormone during the second cycle of in vitro fertilization and embro transfer patients who were failed in the first cycle with early follicular-phase long-acting gonadotropin-releasing hormone agonist long protocol

作　　者：苏琼[1] 伍琼芳[1] 田莉峰[1] 李游[1] 许定飞[1] 高敏 Su Qiong;Wu Qiongfang;Tian Lifeng;Li You;Xu Dingfei;Gao Min(Assisted Reproductive Center,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China)

机构地区：[1]江西省妇幼保健院辅助生殖中心,南昌330006

出　　处：《中华生殖与避孕杂志》2019年第2期87-91,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨重组人生长激素(rhGH)预处理治疗对首次体外受精-胚胎移植(IVF-ET)中采用早卵泡期长方案助孕失败而再次IVF治疗患者的胚胎质量和临床结局的影响。方法通过回顾性队列研究,分析首次使用早卵泡期长效长方案助孕失败且采用相同降调节方案再次助孕治疗的170例患者,按照是否进行rhGH预处理分为研究组(采用rhGH预处理治疗,n=70)及对照组(未使用rhGH预处理治疗,n=100)。比较两组间临床及实验室指标。结果患者年龄、体质量指数(BMI)、不孕年限、基础促卵泡生成素(FSH)、抗苗勒管激素(AMH)、窦卵泡数(AFC)、促性腺激素(Gn)使用时间、Gn使用总剂量、hCG注射日血清雌二醇水平、孕酮水平、子宫内膜厚度、获卵数、双原核(2PN)受精率、卵巢过度刺激综合征(OHSS)发生率、平均移植胚胎数、周期取消率、着床率、宫外孕率和早期流产率组间差异均无统计学意义(P>0.05),但是研究组卵裂率(87.9%)、优质胚胎率(27.8%)、临床妊娠率(51.6%)显著高于对照组(82.9%、21.6%、29.8%)(P=0.019、P=0.022、P=0.007)。结论对于首次使用早卵泡期长效长方案助孕失败的患者,再次助孕时该方案联合rhGH预处理能提高胚胎质量和临床妊娠率。Objective To explore the effects of recombinant human growth hormone (rhGH) pretreatment on the embryo quality and clinical outcomes of patients who experienced a failure cycle with early follicular-phase long-acting gonadotropin-releasing hormone agonist long protocol and received the secondaryin vitro fertilization (IVF) cycle with the same down regulation protocol. Methods This retrospective cohort study was performed among 170 patients who underwent a failure cycle with early follicular-phase long-acting gonadotropin-releasing hormone agonist long protocol. The patients were divided into two groups according to whether received rhGH pretreatment: study group (70 patients with rhGH pretreatment) and control group (100 patients without rhGH pretreatment). The differences of clinical and laboratory indicators between the two groups were retrospectively analyzed. Results Patients’ demographic characteristics did not differ significantly (P>0.05) between the two groups [including age, body mass index (BMI), infertility duration, baseline follicle-stimulating hormone (FSH), baseline anti-Müllerian hormone (AMH) and baseline antral follicle count (AFC)]. And there were no significant differences in the duration of gonadotropin (Gn) used and total dosage of Gn used, serum estradiol and progesterone levels and endometrial thickness on the day of human chorionic gonadotropin (hCG) administration (P>0.05). In study group, similar number of oocytes retrieved, 2 pronucleus(PN) fertilization rate,ovarian hyperstimulation syndrome (OHSS) rate, average number of embryos transferred, cycle cancellation rate, implantation rate, ectopic pregnancy rate and early abortion rate were achieved as compared with control group (P>0.05). The cleavage rate, the good-quality embryo rate, and the clinical pregnancy rate were significantly higher in study group than in control group(P=0.019,P=0.022,P=0.007). Conclusion For patients who were failed in the first cycle with early follicular-phase long-acting gonadotropin-releasing hormone a

关 键 词：受精 体外 胚胎移植 重组人生长激素 早卵泡期长效长方案 胚胎质量 临床结局 

分 类 号：R714.8[医药卫生—妇产科学]