短期同步添加小剂量生长激素在体外受精失败患者再次助孕中的应用研究  

Clinical effect of short-term low-dose growth hormone supplementation in promoting pregnancy in patients with previous in vitro fertilization failure

作　　者：陈巧莉[1] 李竞宇 刘卫卫 张利宏 赵玲 李馥洁[1] 裴莉[1] 叶虹[1] 黄国宁[1] Chen Qiaoli;Li Jingyu;Liu Weiwie;Zhang Lihong;Zhao Lin;Li Fujie;Pei Li;Ye Hong;Huang Guoning(Reproductive and Genetic Research Institute,Chongqing Maternal and Child Health care Hospital)

机构地区：[1]重庆市妇幼保健院遗传与生殖研究所

出　　处：《重庆医科大学学报》2019年第5期653-656,共4页Journal of Chongqing Medical University

基　　金：重庆市科卫联合医学科研资助项目(编号:2018MSXM030);重庆市科卫联合资助项目(编号:2018MSXM034)

摘　　要：目的:研究体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕中同步添加小剂量生长激素(growthhormone,GH)对胚胎质量及助孕结局的影响。方法:以 2017 年 9 月至 2018 年 9 月,前一周期 IVF 助孕未获优质胚胎且未获成功妊娠的 76 例年轻患者(<37 岁)为研究对象,再次助孕采用与前一周期相同的促排卵方案,控制性超排卵(controlled ovarianhyperstimulation,COH)期间同步添加小剂量生长激素,采用自身对照,比较患者前后两次助孕的 Gn 时间、获卵数、获可移植胚胎数、优胚率、子宫内膜厚度、临床妊娠率、着床率和生化/临床妊娠流产率等。结果:患者添加 GH 后,促排卵 Gn 用药总量、停Gn 日血清雌二醇水平、停 Gn 日宫内膜厚度、获卵数、平均可移植胚胎数较前一周期均无统计学差异,无可移植胚胎周期取消率相似(P>0.05),但添加 GH 后 Gn 用药天数缩短[(10.39±1.38) d vs.(11.14±1.78) d,P=0.004],优质胚胎率(18.9% vs.0.0%)、临床妊娠率[51.32%(39/76) vs. 7.89%(6/76)]、着床率[38.73%(55/142) vs. 5.00%(7/140)]均显著提高,差异有统计学意义(P<0.05),生化/临床妊娠流产率无统计学差异(P>0.05)。结论:无明确原因胚胎质量差的患者,再次 IVF 助孕同步添加小剂量 GH,能获得理想的助孕结局。Objective:To investigate the effect of low-dose growth hormone (GH) supplementation on embryo quality and pregnancy outcome in patients undergoing in vitro fertilization-embryo transfer(IVF-ET). Methods:From September 2017 to September 2018, 76 young patients,aged <37 years,who did not obtain a high-quality embryo or achieve successful pregnancy after the previous cycle of IVF,were enrolled as subjects. In the subsequent cycle,the same regimen for ovulation induction was used,and low-dose GH was provided as a supplement during controlled ovarian hyperstimulation(COH). A self-control study was performed to compare duration of gonadotropin(Gn),number of retrieved oocytes,number of transplantable embryos,rate of high-quality embryos,endometrial thickness, clinical pregnancy rate,implantation rate,and chemical or clinical pregnancy loss rate between the two cycles. Results:After the supplementation with GH,there were no significant changes in the total amount of Gn,serum estradiol level on the day of Gn withdrawal,endometrial thickness on the day of Gn withdrawal,number of retrieved oocytes,average number of transplantable embryos,and rate of cancellation due to no transplantable embryos(P>0.05),but there was a significant reduction in the number of days of Gn administration(10.39±1.38 vs. 11.14±1.78,P=0.004) and significant increases in the rate of high-quality embryos (18.9% vs. 0.0%),clinical pregnancy rate[51.32%(39/76) vs. 7.89%(6/76)],and implantation rate [38.73%(55/142) vs. 5.00%(7/140)]. There were no significant change in chemical or clini- cal pregnancy loss rate(P>0.05). Conclusion:For patients with poor embryo quality of unknown causes,low-dose GH supple- mentation in the second cycle of IVF can help to achieve a good pregnancy outcome.

关 键 词：体外受精-胚胎移植 生长激素 胚胎质量 助孕结局 

分 类 号：R698.2[医药卫生—泌尿科学]