不同促排卵方案对卵巢储备功能减退患者体外受精-胚胎移植结局的影响  

Effect of different ovarian stimulation methods on the outcome of in vitro fertilization-embryo transfer in patients with ovarian reserve dysfunction

作　　者：刘曼曼[1] 管一春[1] 刘文霞[1] 杜明泽 刘朝朝 李俊敏[1] 王兴玲[1] LIU Man-man;GUAN Yi-chun;LIU Wen-xia;DU Ming-ze;LIU Zhao-zhao;LI Jun-min;WANG Xing-ling(Department of Reproductive Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第三附属医院生殖医学科

出　　处：《新乡医学院学报》2019年第6期529-532,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨不同促排卵方案对卵巢储备功能减退患者体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析2016年1月至2017年12月于郑州大学第三附属医院进行IVF-ET助孕的150例卵巢储备功能减退患者的临床资料,其中采用促性腺激素释放激素激动剂(GnRHa)长方案促排卵者79例(GnRHa组),采用促性腺激素释放激素拮抗剂(GnRHant)方案促排卵者71例(GnRHant组),对2组不同年龄及不同卵巢反应性患者的窦卵泡计数(AFC)、基础卵泡刺激素(bFSH)、人绒毛膜促性腺激素(HCG)注射日子宫内膜厚度、胚胎着床率、临床妊娠率及早期流产率进行比较。结果2组年龄<35岁患者的AFC、血清bFSH水平、胚胎着床率及早期流产率比较差异无统计学意义(P>0.05),GnRHa组年龄<35岁患者的子宫内膜厚度及临床妊娠率大于GnRHant组(P<0.05)。2组年龄≥35岁患者的AFC、血清bFSH水平、子宫内膜厚度及早期流产率比较差异无统计学意义(P>0.05),GnRHa组年龄≥35岁患者的胚胎着床率及临床妊娠率高于GnRHant组(P<0.05)。2组卵巢低反应性和高反应性者的子宫内膜厚度、胚胎着床率、临床妊娠率及早期流产率比较差异无统计学意义(P>0.05),2组卵巢正常反应性患者的胚胎着床率及早期流产率比较差异无统计学意义(P>0.05),GnRHa组卵巢正常反应性患者的子宫内膜厚度和临床妊娠率高于GnRHant组(P<0.05)。结论使用GnRHa长方案治疗卵巢储备功能减退患者的胚胎着床率和临床妊娠率更高;卵巢正常反应性的卵巢储备功能减退患者采用GnRHa长方案促排卵效果更好,卵巢高反应性和低反应性的卵巢储备功能减退患者采用GnRHa长方案与GnRHant方案促排卵的效果相当。Objective To investigate the effect of different ovarian stimulation methods on the outcome of in vitro fertilization-embryo transfer (IVF-ET) in patients with ovarian reserve dysfunction. Methods The clinical data of 150 cases of ovarian reserve dysfunction treated with IVF-ET in the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2017 were retrospectively analyzed.Seventy-nine cases were treated with gonadotropin-releasing hormone agonist(GnRHa) long protocol (GnRHa group),71 cases were treated with gonadotropin-releasing hormone antagonist(GnRHant)(GnRHant group).The sinus follicle count (AFC),basal follicle stimulating hormone (bFSH),endometrial thickness on the day of human chorionic gonadotrophin(HCG) injection,embryo implantation rate,clinical pregnancy rate and early abortion rate of patients with different age and ovarian reactivity were compared between the two groups. Results There was no significant difference in AFC,serum bFSH level,embryo implantation rate and early abortion rate of patients aged <35 years between the two groups ( P >0.05).The endometrial thickness and clinical pregnancy rate of patients aged <35 years in the GnRHa group were greater than those in the GnRHant group ( P <0.05).There was no significant difference in AFC,serum bFSH level,endometrial thickness and early abortion rate of patients aged ≥ 35 years between the two groups ( P >0.05).The embryo implantation rate and clinical pregnancy rate of patients aged ≥35 years in the GnRHa group were higher than those in the GnRHant group ( P <0.05).There was no significant difference in endometrial thickness,embryo implantation rate,clinical pregnancy rate and early abortion rate of patients with ovarian hyporesponsiveness and hyperresponsiveness between the two groups ( P >0.05).There was no significant difference in embryo implantation rate and early abortion rate of patients with normal ovarian responsiveness between the two groups ( P >0.05).The endometrial thickness and clinical pregnancy rate o

关 键 词：卵巢储备功能减退 体外受精-胚胎移植 促性腺激素释放激素激动剂 促性腺激素释放激素拮抗剂 妊娠结局 

分 类 号：R246.3[医药卫生—针灸推拿学]