卵泡期高孕激素状态下促排卵方案与微刺激方案应用于卵巢低反应人群的效果比较  

Comparison of progestin primed ovarian stimulation and micro-stimulation protocol in patients with poor ovarian response

作　　者：徐少蓉 吴延[1] 周孟君[1] 赖婷 李丹[1] 马琴芹 路巍 李俊林[1] 何玮[1] 李润[1] 郭翠翠 张耀[1] XU Shao-rong;WU Yan;ZHOU Meng-jun;LAI Ting;LI Dan;MA Qin-qin;LU Wei;LI Jun-lin;HE Wei;LI Run;GUO Cui-cui;ZHANG Yao(Mianyang Central Hospital,Mianyang 621000)

机构地区：[1]绵阳市中心医院,绵阳621000

出　　处：《生殖医学杂志》2020年第9期1162-1167,共6页Journal of Reproductive Medicine

基　　金：四川省卫生和计划生育委员会科研项目(18PJ072)。

摘　　要：目的探讨卵泡期高孕激素状态下促排卵(PPOS)方案与微刺激方案在卵巢低反应(POR)人群中的应用效果。方法收集2017年9月至2019年12月在我院生殖医学中心行IVF/ICSI-ET助孕的POR患者(共74个周期)的临床资料。根据控制性促排卵方案不同将所有POR患者分为两组:PPOS组(55个周期)和微刺激组(19个周期),比较两组患者的一般资料、促排卵情况及胚胎实验室指标。结果两组患者的一般资料比较均无显著性差异(P>0.05)。PPOS组的Gn天数、Gn总量、HCG日E2水平、HCG日≥14 mm卵泡数显著高于微刺激组(P<0.05);PPOS组HCG日LH水平显著低于微刺激组(P<0.05);两组的HCG日P水平无显著性差异(P>0.05)。PPOS组无早发LH峰出现,微刺激组2例出现早发LH峰。PPOS组获卵数显著高于微刺激组(3.0 vs.2.0)(P<0.05);PPOS组与微刺激组的MⅡ卵率(94.6%vs.95.5%)、正常受精率(67.7%vs.64.3%)、卵裂率(97.0%vs.97.4%)、优质胚胎率(46.8%vs.29.6%)、可利用胚胎率(69.8%vs.52.6%)比较均无显著性差异(P>0.05)。结论PPOS方案可以改善卵巢反应性,有效抑制早发LH峰,对于POR患者是一种可选择的促排卵方案。Objective:To investigate the effect of progestin primed ovarian stimulation(PPOS)and micro-stimulation protocol in the patients with poor ovarian response(POR).Methods:A prospective study was carried out for 74 infertile POR patients undergone IVF/ICSI-ET.The patients were divided into two groups:the PPOS group(n=55)and the micro-stimulation group(n=19).The general characteristics,ovarian stimulation status and embryo laboratory indicators were compared between the two groups.Results:There were no significant differences in general characteristics between the two groups(P>0.05).The gonadotropin(Gn)days,Gn doses,the E2 level and the number of follicles≥14 mm on HCG day in PPOS group were significantly higher than those in micro-stimulation group(P<0.05).The LH levels on HCG day in PPOS group were significantly lower than those in micro-stimulation group(P<0.05).There were no significant differences in the P levels on HCG day between the two groups(P>0.05).No premature LH peak was found in PPOS group and there were 2 cases in micro-stimulation group.The number of oocytes retrieved in PPOS group were significantly higher than micro-stimulation group(3.0 vs.2.0)(P<0.05).There were no significant differences in MⅡoocytes rate(94.6%vs.95.5%),2PN rate(67.7%vs.64.3%),cleavage rate(97.0%vs.97.4%),high quality embryo rate(46.8%vs.29.6%)and available embryo rate(69.8%vs.52.6%)between the two groups(P>0.05).Conclusions:PPOS protocol can improve ovarian response and effectively control premature LH surge.PPOS protocol is an alternative ovulation induction protocol for POR patients.

关 键 词：卵泡期高孕激素状态下促排卵 微刺激方案 卵巢低反应 控制性促排卵 

分 类 号：R711.6[医药卫生—妇产科学]