卵泡期长效长方案在不同卵巢反应患者中的应用分析  

Application of long-acting GnRH agonist protocol during follicular phase in patients with different ovarian response

作　　者：张杰[1] 许月明[1] 郝桂敏[1] ZHANG Jie;XU Yue-ming;HAO Gui-min(The Second Hospital of Hebei Medical University,Shijiazhuang 050000)

机构地区：[1]河北医科大学第二医院,石家庄050000

出　　处：《生殖医学杂志》2020年第10期1322-1327,共6页Journal of Reproductive Medicine

摘　　要：目的探讨卵泡期长效长方案在不同卵巢反应患者中的治疗效果。方法回顾性分析2015年1月至2019年1月在本院生殖医学中心行IVF/ICSI-ET助孕第1周期鲜胚移植的患者资料共7323例(7323周期),根据促排卵方案不同分为黄体期短效长方案组(A组,n=4379)和卵泡期长效长方案组(B组,n=2944);各方案组再根据获卵数分为不同亚组:获卵数<5者为A1组(n=346)、B1组(n=171),5≤获卵数≤15为A2组(n=3280)、B2组(n=2122),获卵数>15者为A3组(n=753)、B3组(n=651)。统计分析各组间患者基本资料、获卵移植情况及妊娠结局。结果(1)与A1组相比,B1组基础窦泡数、Gn天数、Gn剂量显著升高,HCG日LH及孕酮值显著降低(P<0.05);两组间胚胎情况与妊娠结局无显著性差异(P>0.05)。(2)与A2组相比,B2组的基础LH水平、基础窦泡数、Gn天数、Gn总量显著升高,而HCG日LH、E2、P水平显著降低(P<0.05);B2组的获卵数和MⅡ卵数较A2组显著升高,但可移植胚胎数及移植胚胎数显著下降(P<0.05);B2组的临床妊娠率及活产率较A2组显著升高,而异位妊娠率显著下降(P<0.05)。(3)与A3组相比,B3组的基础LH、基础窦泡数、Gn天数和Gn总量显著升高,HCG日LH、E2、孕酮水平显著降低(P<0.05);B3组的获卵数和MⅡ卵数显著高于A3组,而可移植胚胎数却显著低于A3组(P<0.05);两组间妊娠结局无显著性差异(P>0.05)。结论卵泡期长效长方案在各种卵巢反应的患者的新鲜周期治疗中均可取得不劣于经典长方案的治疗结果。Objective:To study the therapeutic effect of long-acting GnRH agonist protocol during follicular phase in patients with different ovarian response.Methods:The data of 7323 cycles of the first of IVF/ICSI-ET in our center from January 2015 to January 2019 were retrospectively analyzed.According to the different ovulation induction protocols,the cycles were divided into the luteal phase short-acting long-term protocol group(group A,n=4379)and the follicular phase long-acting long-term protocol group(group B,n=2944).Each group was divided into different subgroups according to the number of oocytes retrieved:number of oocytes<5 in group A1(n=346)and B1(n=171),5≤number of oocytes≤15 in group A2(n=3280)and B2(n=2122),number of oocytes>15 in group A3(n=753)and B3(n=651).The basic information of patient,oocyte transfer status and pregnancy outcome were analyzed and compared among the groups.Results:(1)Compared with group A1,group B1 had significantly more basal antral follicles,longer Gn days,larger amount of total Gn dosage,lower LH and progesterone levels on HCG day(P<0.05).There was no difference in pregnancy outcome between the two groups(P>0.05).(2)group B2 had significantly higher basal LH level,more basal antral follicles,longer Gn days,larger total Gn dosage,lower LH and E2 and progesterone levels on HCG day compared with group A2(P<0.05).The number of oocytes and MⅡoocytes retrieved in group B2 were significantly higher than those in group A2,but the number of transferable embryos and embryos transferred significantly decreased(P<0.05).The clinical pregnancy rate and live birth rate of group B2 were significantly higher than those of group A2,while the ectopic pregnancy rate was significantly decreased(P<0.05).(3)Compared with group A3,the basal LH,number of basal antral follicles,Gn days and total Gn dosage were significantly increased,and the levels of LH,E2 and progesterone on HCG day in group B3 were significantly decreased(P<0.05).The number of oocytes and MⅡoocytes retrieved in group B3 were signif

关 键 词：卵泡期长效长方案 黄体期短效长方案 卵巢反应 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]