不同年龄卵巢低反应患者应用高孕激素状态促排卵方案的研究  

Study of the application of progestin-primed stimulation protocol for treating different age women with poor ovarian response

作　　者：张丽 魏学聪 张欣 王雪莹 姚冠峰 扈淑红 刘效群 ZHANG Li;WEI Xuecong;ZHANG Xin;WANG Xueying;YAO Guanfeng;HU Shuhong;LIU Xiaoqun(Hebei Family Planning Science & Technology Research Institute, Key Laboratory of Family Planning & Health Birth, National Health & Family Planning Commission, Shijiazhuang, Hebei Province, 050071)

机构地区：[1]河北省计划生育科学技术研究院,国家卫计委计划生育与优生重点实验室,石家庄050071

出　　处：《中国计划生育学杂志》2020年第3期399-403,共5页Chinese Journal of Family Planning

基　　金：河北省医学科学研究课题计划(20190144)。

摘　　要：目的:探讨不同年龄卵巢低反应(POR)患者采用高孕激素状态下促排卵方案(PPOS)体外受精/卵母细胞浆内单精子注射(IVF/ICSI)的结局。方法:选择2015年1月-2018年5月于本中心采用PPOS方案IVF/ICSI助孕的POR患者为研究对象,根据患者年龄分为<30岁组;30~34岁组;35~39岁组;≥40岁组,分析4组IVF/ICSI结局。结果:<30岁组Gn总量高于≥40岁组,获卵数和MII卵数高于35~39岁组、≥40岁组(均P<0.05)。4组IVF受精率、2PN数、可利用胚胎数,优质胚胎数和周期取消率比较均无差异(P>0.05)。≥40岁组的临床妊娠率及种植率低于<30岁组、30~34岁组,抱婴率低于另外3组(均P'<0.007)。结论:不同年龄段POR患者应用PPOS方案,均能较好的抑制早发LH峰,可利用胚胎数和优质胚胎数相同,但>40岁患者临床妊娠率、种植率和抱婴率低。Objective:To investigate the outcomes of progestin-primed stimulation(PPOS)protocol for treating different age women with poor ovarian response(POR)after vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods:From January 2015 to May 2018,the women with POR who were underwent IVF/ICSI after treated by PPOS protocol were divided into group A(women with<30 years old),group B(women with 30-34 years old),group C(women with 35-39 years old),and group D(women with≥40 years old).The IVF/ICSI outcomes of women in the four groups were analyzed retrospectively.Results:The total Gn usage of women in group A was significant higher than that of women in group D(P<0.05).The numbers of eggs obtained and MII eggs of women in group A were significant higher than those of women in group C and D(P<0.05).There were no significant different in IVF fertilization rate,2PN number,available number of embryos,number of high-quality embryos,and cycle cancellation rate of women among the four groups(P>0.05).The clinical pregnancy rate and implant rate of embryos of women in group D were significant lower than those of women in group A and B(chi-square segmentation,P<0.007).The rate of baby taken home in group D was significant lower than that in the other three groups(chi-square segmentation,P<0.007).Conclusion:PPOS protocol used for different age women with POR is able to inhibit the early onset LH peak.The number of available embryo and the number of high-quality embryos are similar among women with different age,but the clinical pregnancy rate,implant rate of embryos,and the rate of baby taken home of POR women with>40 years old are low.

关 键 词：卵巢低反应 体外受精/卵母细胞浆内单精子注射 高孕激素状态下促排卵 卵巢储备功能减退 

分 类 号：R714.8[医药卫生—妇产科学]