拮抗剂方案的黄体期添加GnRH-a在IVF新鲜周期中的应用  

Application of GnRH Agonistin the Luteal Phase of GnRH-Antagonist Protocolin FreshIVF Cycle

作　　者：李洁 杨丽娟[1] 李琳[1] 胥杜娟 马玲 LI Jie;YANG Li-juan;LI Lin;XU Du-juan;MA Ling(Reproductive Hospital of Jiang Xi University of Traditional Chinese Medicine,Nanchang 330000 China)

机构地区：[1]江西中医药大学附属生殖医院生殖医学科,江西南昌330000

出　　处：《现代诊断与治疗》2020年第1期1-5,共5页Modern Diagnosis and Treatment

基　　金：南昌市科技局(市级项目:洪科字[2018]235号)。

摘　　要：目的研究拮抗剂方案的黄体期添加GnRH-a对IVF新鲜移植周期妊娠结局的影响。方法选择行IVF助孕的211对患者,均采用拮抗剂方案促排卵治疗,根据黄体支持方案的不同随机分为试验组105例和对照组106例。试验组在常规黄体支持的基础上,在胚胎移植后d0、d2分别添加短效GnRH-a各0.1mg,对照组则无任何添加。取卵后第2,4,6,8d分别抽血测量E2,胚胎移植后12d抽血测β-HCG,E2及P,移植后28d行经阴道彩超。比较两组的一般情况,临床及实验室相关指标。结果试验组和对照组一般情况相比较,差异均无统计学意义(P>0.05)。试验组和对照组的Gn总量、Gn天数、HCG日内膜厚度、HCG日E2值、获卵数、移植胚胎数、取卵后2dE2值、取卵后8dE2值、受精方式相比较,差异均无统计学意义(P>0.05);试验组和对照组取卵后4dE2值、取卵后6dE2值相比较,差异有统计学意义(P<0.05),试验组和对照组的胚胎种植率分别为44.62%(83/186)、34.25%(62/181),生化妊娠率分别为68.57%(72/105)、54.72%(58/106),临床妊娠率分别为62.86%(66/105)、49.06%(52/106),异位妊娠率分别为0.00%(0/61)、1.92%(1/52),早期流产率分别为4.92%(3/61)、3.85%(2/52),OHSS发生率分别为1.90%(2/105)、0.00%(0/106),试验组和对照组的胚胎着床率、生化妊娠率、临床妊娠率相比较,差异有统计学意义(P<0.05),早期流产率、异位妊娠率、OHSS发生率相比较,差异无统计学意义(P>0.05)。结论拮抗剂方案的黄体期添加短效GnRH-a可提高雌激素水平,改善新鲜移植周期的妊娠结局,是一项不错的黄体支持的药物选择。Objective To investigate the effect of adding GnRH agonist(GnRH-a)in the luteal phase of GnRHantagonist protocol in freshIVF cycle.Methods 211 patients who undergoing fresh IVF-ET cycle with GnRHantagonist protocol in our center.According to the different luteal support schemes,they were randomly divided into two groups:the control group and the test group.For the test group,0.1 mgGhRH-a was respectivelyadded at the D0 and D2 after transfer on the basis of traditional luteal support,while no GnRH-a was added to the control group.E2 levels were measured on day 2,4,6 and 8 after pick up oocytes,and Hcg,E2 and P levelwere measured on day 12 after transplantation.Transvaginal color doppler ultrasound was performed on day 28 after transplantation.The general conditions,clinical and laboratory indicators of the two groups were compared.Results There was no significant difference inbasic conditionsbetween the test group and the control group(P>0.05).Gn total,Gn days,endometrial thickness and E2 level on the day of hCGinjection,thenumber of retrieved oocyte,the number of transferred embryo,E2 level on 2 days and 8 days after pick up oocytes,fertilization method were compared between the test group and the control group,the differences were not statistically significant(P>0.05).E2 level on 4 days and 6 days after pick up oocytes between the test group and the control group were compared,the difference was statistically significant(P<0.05).Embryo implantation ratewas of thetest group and the control grouprespectively 44.62%(83/186),34.25%(62/181),biochemical pregnancy rate was respectively 68.57%(72/105),54.72%(58/106),the clinical pregnancy rate was respectively 62.86%(66/105),49.06%(52/106),ectopic pregnancy rate was respectively0.00%(0/61)and 1.92(1/52),The rate of early abortion was respectively4.92%(3/61)and 3.85%(2/52),and the incidence of OHSS was respectively1.90%(2/105)and 0.00%(0/106).The embryo implantation rate,biochemical pregnancy rate,clinical pregnancy ratewere compared,and the difference was statistically

关 键 词：拮抗剂方案 达必佳 新鲜移植 妊娠结局 

分 类 号：R715.9[医药卫生—妇产科学]