卵泡期超长方案在高龄患者IVF/ICSI治疗中的应用  

Application of prolonged protocol in aged women undergoing IVF/ICSI treatment

作　　者：卢晓声[1] 吴燕虹[1] 习海涛[1] 苏玮珏 赵军招[1] LU Xiaosheng;WU Yanhong;XI Haitao;SU Weijue;ZHAO Junzhao(Reproductive Center, the Second Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou 325027, China;the Second Clinical College of Wenzhou Medical University, Zhejiang Province, Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第二医院生殖医学中心,浙江温州325027 [2]温州医科大学第二临床学院,浙江温州325000

出　　处：《中国医药导报》2019年第18期94-98,共5页China Medical Herald

基　　金：浙江省温州市生殖遗传创新团队项目(C20170007);浙江省自然科学基金项目(LQ17H040003)

摘　　要：目的评估卵泡期超长方案在高龄女性行体外受精/卵母细胞浆内单精子注射(IVF/ICSI)助孕治疗中的可行性。方法回顾性分析2016年7月~2018年7月在温州医科大学附属第二医院生殖中心行IVF/ICSI新鲜胚胎移植的高龄患者333例,其中143例采用微刺激方案,190例采用卵泡期超长方案。对比两种方案的实验室和临床结局。进一步将行卵泡期超长方案的患者分为>35~38岁组(107例)和>38~42岁组(83例),比较两组患者的实验室及临床结局。结果相比采用微刺激方案的患者,卵泡期超长方案的患者使用了更多的促性腺素和更长的超促排卵时间,但获得了更高的临床妊娠率和胚胎种植率。>38~42岁组的超高龄患者在使用卵泡期超长方案后,获得了与>35~38岁组高龄患者类似的临床妊娠率(P> 0.05),但胚胎种植率较>35~38岁组高龄患者低(P <0.05)。结论对于卵巢储备功能尚可的高龄患者(年龄≤42周岁、窦卵泡数≥5个、基础卵泡刺激素≤12 U/L),卵泡期超长方案是可行的并可作为首选的超促排卵方案。Objective To assess the feasibility of prolonged protocol performed in aged patients undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI) treatment. Methods A Retrospective analysis was conducted on the data of 333 aged women who were given IVF/ICSI treatment with fresh embryo transplantation in the Reproductive Center of the Second Affiliated Hospital of Wenzhou Medical University from July 2016 to July 2018,of which 143 cases were given mild stimulation,and 190 cases were given prolonged protocol. The laboratory and clinical outcomes of two schemes were compared. Then patients in prolonged group were further divided into two groups according to their age. one included 107 cases aged >35-38 years old and the other contained 83 cases aged >38-42 years old,and laboratory and clinical outcomes were compared between the groups. Results Patients with the prolonged protocol used more doses of gonadotropin and longer treatment duration than those with mild stimulation, but patients with prolonged protocol achieved higher clinical pregnancy rates and embryo implantation rates. In patients with mild stimulation,the clinical pregnancy rate of patients aged >38-42 years old group was similar to that of the >35-38 year-old group(P >0.05),while the embryo implantation rate was lower than the >35-38 year-old group(P < 0.05). Conclusion The prolonged protocol is expected to be one of preferred option for elderly patients with tolerable ovarian reverse(≤ 42 years old, AFC≥5 and basic FSH≤12 U/L).

关 键 词：卵泡期超长方案 高龄 卵巢储备功能 体外受精 卵母细胞浆内单精子注射 

分 类 号：R711.6[医药卫生—妇产科学]