卵巢低反应高龄患者使用来曲唑联合克罗米芬和全程克罗米芬的温和刺激方案实验室结局的比较  

Comparing the laboratory outcome after letrozole combined with clomiphene versus clomiphene treatment for mild ovarian stimulation protocol in aged poor ovarian responders

作　　者：何晓霞[1] 张莉莉[1] 石馨[1] 张学红[1] He Xiaoxia;Zhang Lili;Shi Xin;Zhang Xuehong(The Reproductive Medicine Special Hospital of the 1st Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou 730000, China)

机构地区：[1]兰州大学第一医院生殖医学专科医院,甘肃省生殖医学与胚胎重点实验室,730000

出　　处：《中华生殖与避孕杂志》2019年第4期306-309,共4页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨来曲唑+克罗米芬(CC)与全程CC联合促性腺激素(Gn)两种温和刺激方案对卵巢低反应高龄患者实验室治疗结局的影响。方法回顾性分析2015年1月—2017年12月期间在兰州大学第一医院生殖医学专科医院接受体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)的卵巢低反应高龄患者376例,根据促排卵方案分为来曲唑+CC方案组(A组,n=209)和全程CC方案组(B组,n=167),比较两组患者的实验室治疗结局。结果A组的获卵率(91.9%)、获卵数(2.85±1.96)、卵裂率(97.2%)及可用胚胎率(84.5%)均显著高于B组(84.4%,2.31±1.95,86.5%,73.8%),IVF/ICSI受精率(70.6%/77.0%)和周期取消率(26.3%)显著低于B组(80.9%/89.3%,40.1%)(P<0.05);两组患者的MII卵率、双原核(2PN)率及优质胚胎率组间差异均无统计学意义(P>0.05)。结论对卵巢低反应高龄患者采用来曲唑+CC联合Gn温和刺激方案较全程CC联合Gn方案能够有效降低周期取消率,并且可以获得更高的可用胚胎率。Objective To compare the laboratory treatment outcomes after letrozole and clomiphene versus clomiphene treatment for mild ovarian stimulation protocol in aged poor ovarian responders. Methods This retrospective study conducted from January 2015 to December 2017 in the Reproductive Medicine Special Hospital of the 1st Hospital of Lanzhou University. A total of 376 poor ovarian responders were divided into two groups based on the regimes of ovarian, letrozole and clomiphene (group A, n=209) and clomiphene (group B, n=167). Both groups were used in conjunction with gonadotropin. Laboratory treatment outcomes were compared. Results The rates of oocyte-obtained (91.9%), cleavage (97.2%), available embryo (84.5%) and the number of retrieved oocytes (2.85±1.96) were significantly higher in group A than in group B (84.4%, 86.5%, 73.8%, 2.31±1.95)(P<0.05). The rate of in vitro fertilizatoin/intracytoplasmic sperm injection(IVF/ICSI) fertilization (80.9%/89.3%) and cancellation rate (40.1%) were higher in group B than in group A (70.6%/77.0%, 26.3%)(P<0.05). No significant differences were found in the MII oocyte rate, 2 pronucleus (PN) rate and high-quality embryo rate between the two groups (P>0.05). Conclusion The mild ovarian stimulation use letrozole and clomiphene could reduce the cancellation rate effectively, and achieved higher rate of available embryo.

关 键 词：受精 体外 胚胎移植 高龄 卵巢低反应 温和刺激 

分 类 号：R714.8[医药卫生—妇产科学]