口服避孕药在卵巢低反应患者控制性超促排卵前期处理中的临床作用  

Effect of oral contraceptive pill pretreatment on the patients with poor ovarian response prior to controlled ovarian hyperstimulation

作　　者：李昕[1] 尚鶄[1] 徐阳[1] 薛晴[1] Li Xin;Shang Jing;Xu Yang;Xue Qing(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,100034

出　　处：《中华生殖与避孕杂志》2019年第9期712-715,共4页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨卵巢低反应(POR)患者在接受促性腺激素释放激素拮抗剂(GnRH-A)方案控制性超促排卵(COH)前一周期使用口服避孕药(OCP)预处理的临床价值.方法将2013年1月至2017年12月期间在北京大学第一医院妇产科接受体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)的POR患者559例按照COH前是否接受OCP治疗分为OCP组(n=161)和对照组(n=398),对入选患者的病历资料进行回顾分析.结果 OCP组患者促性腺激素使用总量[(31.19±17.03)支]及使用时间[(8.64±2.92)d]较对照组减少[(38.96±13.92)支,P<0.001;(9.38±2.26)d,P=0.004],周期取消率(14.91%)较对照组降低(25.13%,P=0.008),且获卵数(3.74±1.31)、MI卵子数(3.00±1.12)、活产率(26.28%)较对照组升高(3.44±1.36,P=0.030;2.74±1.26,P=0.030;17.45%,P=0.033),差异均有统计学意义.结论 POR患者接受GnRH-A前OCP预处理可降低周期取消率,改善临床结局.Objective To determine whether the use of oral contraceptive pill (OCP) pretreatment prior to gonadotropin-releasing hormone antagonist (GnRH-A) protocol would improve the outcome of poor ovarian responders. Methods Totally 559 poor ovarian responders undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles in Department of Obstetrics and Gynecology, Peking University First Hospital from January 2013 to December 2017 were divided into two groups according to the history whether the patients had been treated with OCP before the ovulatory period (OCP group, n=161;control group, n=398). Clinical data of these 559 patients were retrospectively analyzed. Results The required ampoules (31.19±17.03) and the duration of gonadotropin [(8.64±2.92) d] were lower in patients pretreatment with OCP than that in patients of control group [38.96±13.92, P<0.001;(9.38±2.26) d, P=0.004]. The cycle cancelled rate in patients of the OCP group (14.91%) was also lower than in patients of control group (25.13%, P=0.008). The number of oocyte retrieval (3.74±1.31), the number of MII oocyte (3.00±1.12) and the live birth rate (26.28%) were significantly higher in patients pretreatment with OCP than in patients of control group (3.44±1.36, P=0.030;2.74±1.26, P=0.030;17.45%, P=0.033). All the differences were statistically significances. Conclusion OCP administered before IVF-ET/ICSI were shown to improve the effect of ovulation-promotive treatment and decrease the cycle cancelled rate in poor ovarian responders.

关 键 词：受精 体外 卵胞质内单精子注射 卵巢低反应 口服避孕药 

分 类 号：R714.8[医药卫生—妇产科学]