GnRH-a超长过渡方案对子宫内膜异位症IVF-ET后性激素、妊娠率及不良妊娠结局的影响  

Effects of GnRH-a extra long transition scheme on sex hormone,pregnancy rates and adverse pregnancy outcomes in endometriosis after IVF-ET

作　　者：江璐[1] 张莉[1] 程建云[1] JIANG Lu;ZHANG Li;CHENG Jian-yun(Department of Gynecology,the First Affiliated Hospital of Xinjiang Medical University 830000)

机构地区：[1]新疆医科大学第一附属医院妇科

出　　处：《中国优生与遗传杂志》2019年第8期1010-1012,1019,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的观察促性腺激素释放激素激动剂(GnRH-a)超长过渡方案对子宫内膜异位症患者行体外受精-胚胎移植(IVF-ET)后性激素、妊娠率及不良妊娠结局的影响。方法选取2016年1月~2018年1月期间医院收治的子宫内膜异位症IVF-ET150例,采用随机数表法将患者分为超长过渡组、长过渡组和短过渡组,每组50例。短过渡组给予GnRH-a短效过渡方案治疗,长过渡组给予GnRH-a长效过渡方案治疗,超长过渡组给予GnRH-a超长效过渡方案治疗,3组均给予IVFET和孕三烯酮治疗。对比3组助孕作用;对比3组治疗前后血卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E2)水平;对比3组妊娠率和不良妊娠结局情况。结果超长过渡组获卵率、受精率、优胚率与长过渡组、短过渡组相比显著较高(P<0.05),长过渡组与短过渡组相比显著较高(P<0.05);治疗后3组FSH、LH、E2水平均显著低于治疗前(P<0.05),且治疗后3组相比,超长过渡组E2水平均显著高于长过渡组、短过渡组(P<0.05),长过渡组显著高于短过渡组(P<0.05),FSH、LH水平差异均不显著(P>0.05);超长过渡组妊娠率显著高于长过渡组、短过渡组(P<0.05);3组相比,各项不良妊娠结局发生率差异均不显著(P>0.05)。结论 GnRH-a超长过渡方案对子宫内膜异位症IVF-ET后助孕作用理想,GnRH-a短过渡方案、长过渡方案、超长过渡方案均可以改善性激素水平,且GnRH-a超长过渡方案效果最佳,GnRH-a超长过渡方案对妊娠率改善作用显著优于短过渡方案、长过渡方案,GnRH-a短过渡方案、长过渡方案、超长过渡方案不良妊娠结局发生率相近。Objective:To observe the effects of gonadotropin-releasing hormone agonist(GnRH-a)on sex hormones,pregnancy rates and adverse pregnancy outcomes in patients with endometriosis after in vitro fertilization-embryo transfer(IVFET). Methods:150 patients of IVF-ET with endometriosis were selected from January 2016 to January 2018. The patients were randomly divided into super-long transition group,long transition group and short transition group with 50 cases in each group. The short transition group were treated with GnRH-a short-term transition regimen,the long transition group were treated with GnRH-a long-term transition regimen,and the super long transition group were treated with GnRH-a super long-term transition regimen,and the 3 groups were treated with IVF-ET and gestrinone. The effects of assisted pregnancy were compared among the 3 groups. The levels of follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)were compared among the 3 groups,and the pregnancy rates and adverse pregnancy outcomes were compared among the 3 groups. Results:The oviposition rates,fertilization rates and good embryo rates of the super-long transition group were significantly higher than those of the long transition group and the short transition group(P<0.05),and the long transition group were significantly higher than that of the short transition group(P<0.05). The levels of FSH,LH and E2 in the 3 groups after treatment were significantly lower than those before treatment(P<0.05). The levels of E2 in the super-long transition group was significantly higher than those of the long transition group and the short transition group after treatment(P<0.05),and the long transition group was significantly higher than the short transition group(P<0.05). There were no significant difference in the levels of FSH and LH among the 3 groups(P>0.05). The pregnancy rates of the super long transition group was significantly higher than those of the long transition group and the short transition group(P<0.05). There were no signif

关 键 词：子宫内膜异位症 促性腺激素释放激素激动剂 体外受精-胚胎移植 不良妊娠结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]