不同促排卵方案对不同年龄卵巢低反应患者IVF-ET助孕效果  

Effect of different ovarian stimulation regimen for treating different age women with poor ovarian response assisted by IVF-ET

作　　者：董佳倩 沈莉萍 王春春 DONG Jiaqian;SHEN Liping;WANG Chunchun(Shanghai Changning District Maternal and Child Health Care Hospital, Shanghai, 200232)

机构地区：[1]上海市长宁区妇幼保健院,200232

出　　处：《中国计划生育学杂志》2020年第8期1208-1212,共5页Chinese Journal of Family Planning

摘　　要：目的:探究不同促排卵方案对不同年龄卵巢低反应(POR)患者体外受精-胚胎移植(IVF-ET)助孕的临床效果。方法:前瞻性选择2016年8月—2019年8月在上海某医院接受IVF-ET助孕的POR患者336个周期,根据年龄及方案不同分为<35岁长效组(年龄<35岁,早卵泡期长效长方案,75周期)、<35岁拮抗组(年龄<35岁,拮抗剂方案,81周期)、≥35长效组(年龄≥35岁,早卵泡期长效长方案,87周期)、≥35拮抗组(年龄≥35岁,拮抗剂方案,93周期),比较<35岁长效与拮抗组、≥35岁长效与拮抗组的临床指标及临床结局。结果:<35岁长效组Gn使用总量、Gn使用时间、hCG日子宫内膜厚度明显高于拮抗组,hCG日雌二醇(E2)、促黄体生成素(LH)、孕酮(P)水平均低于拮抗组,受精率、可用胚胎率、胚胎种植率、妊娠率等高于拮抗组(均P<0.05),周期取消率、优质胚胎率、流产率、多胎率、异位妊娠率、早产率、新生儿体重等与拮抗组无差异(P>0.05);≥35长效组Gn使用总量、Gn使用时间、hCG日子宫内膜厚度均高于拮抗组,hCG日LH、E2、P水平均低于拮抗组,胚胎种植率、妊娠率均高于拮抗组(均P<0.05),周期取消率、受精率、可用胚胎率、优质胚胎率、流产率、多胎率、异位妊娠率、早产率、新生儿体重等与拮抗组无差异(P>0.05)。结论:早卵泡期长效长方案可改善不同年龄IVF-ET助孕卵巢低反应患者临床结局,具有较好的临床应用价值,但会增加Gn使用总量和使用时间,增加费用。Objective:To investigate the clinical effect of different ovarian stimulation regimen for treating different age women with poor ovarian response(POR)assisted by in vitro fertilization-embryo transfer(IVF-ET).Methods:336 cycles of women with POR who received IVF-ET were selected in this study from August 2016 to August 2019.They were divided into group A(age<35 years old,long-term regimen during early follicular phase,75 cycles),group B(age<35 years old,antagonist regimen,81 cycles)and group C(age≥35 years old,long-term regimen during early follicular phase,87 cycles),and group D(age≥35 years old,antagonist regimen,93 cycles).The clinical indicators and outcomes of women were compared among the four groups.Results:The total dosage of Gn,duration of Gn used,the endometrial thickness on the hCG day,the rates of fertilization,the available embryo number,the embryo implantation rate,and the pregnancy rate of women in group A were significant higher than those of women in group B,but the levels of estradiol(E2),luteinizing hormone(LH)and progesterone(P)on hCG day of women in group A were significant lower(all P<0.05).There were no significant difference in the rates of cancellation,high quality embryo,abortion,multiple pregnancy,ectopic pregnancy,and preterm birth,and neonatal weight of women between group A and B(P>0.05).The total dosage of Gn,duration of Gn used,the endometrial thickness on the hCG day,and the rates of the embryo implantation and pregnancy of women in group C were significant higher than those of women in group D,but the levels of E2,LH and P on the hCG day of women in group C were significantly lower(P<0.05).There were no significant difference in the rates of cycle cancellation,fertilization,available embryo,high quality embryo,abortion,multiple pregnancy,ectopic pregnancy,and preterm birth,and neonatal weight of women between group C and D(P>0.05).Conclusion:Application of long protocol during early follicular phase can effectively improve the clinical outcomes of different age women with POR

关 键 词：体外受精-胚胎移植 卵巢低反应 不同年龄 早卵泡期长效长方案 拮抗剂方案 临床效果 

分 类 号：R71[医药卫生—妇产科学]