卵泡期高孕激素状态下促排卵方案与拮抗剂方案在预期卵巢低反应患者中的应用比较  

Comparison of Ovulation Induction and Antagonist Program in Expected Poor Ovarian Response Patients Under High Progesterone State During Follicular Phase

作　　者：黄丽萨[1] 张耀[1] 杨德辉[1] 马琴芹 何玮[1] 郭翠翠 赵敏 张天生[1] 李丹[1] Huang Lisa;Zhang Yao;Yang Dehui(Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市中心医院,四川绵阳621000

出　　处：《四川医学》2020年第9期938-941,共4页Sichuan Medical Journal

摘　　要：目的比较卵泡期高孕激素状态下促排卵方案与拮抗剂方案在预期卵巢低反应患者中应用的临床效果。方法回顾性分析2017年10月至2019年12月,在我院行IVF/ICSI助孕的93例预期卵巢低反应患者的临床资料,根据波塞冬预期低反应分类标准及控制性促排卵方案分为4组:A1组:年龄≥35岁,抗苗勒管激素(AMH)<1.2 ng/ml,基础窦卵泡数(AFC)<5个,采用PPOS方案;A2组:年龄≥35岁,AMH<1.2 ng/ml,AFC<5个,采用拮抗剂方案;B1组:年龄<35岁,AMH<1.2 ng/ml,AFC<5个,采用PPOS方案;B2组:年龄<35岁,AMH<1.2 ng/ml,AFC<5个,采用拮抗剂方案。比较各组患者的一般资料、促排卵情况及实验室指标。结果不同年龄组的两种促排卵方案间患者年龄、不孕年限、体质指数、AFC、AMH均无统计学差异(P>0.05);A1组与A2组获卵数、2PN数、可利用胚胎数比较无统计学差异(P>0.05),A1组Gn天数、Gn总量、D3优质胚胎数、D3优质胚胎率略高于A2组,但差异无统计学意义;B1组Gn天数、Gn总量、D3优质胚胎数、D3优质胚胎率略高于B2组,但差异无统计学意义(P>0.05),B2组获卵数、2PN数、可利用胚胎数高于B1组,但差异无统计学意义(P>0.05)。结论卵泡期高孕激素状态下促排卵方案应用于年龄≥35岁的预期卵巢低反应患者,可获得较满意的临床效果,可作为高龄卵巢低反应患者控制性促排卵方案选择之一。Objective To compare clinical effects of progestin primed ovarian stimulation(PPOS)and antagonist program in patients with poor ovarian response(POR)during follicular phase.Methods From October 2017 to December 2019,clinical data of 93 patients with expected POR who underwent IVF/ICSI in our hospital were retrospectively analyzed.According to classification criteria of Poseidon’s expected poor response and controlled ovulation induction,program was divided into 4 groups:Group A1 was that age was≥35 years old,AMH<1.2 ng/ml,AFC<5,using PPOS program.Group A2 was that age was≥35 years old,AMH<1.2 ng/ml,AFC<5 One,using antagonist program.Group B1 was that age was less than 35 years old,AMH<1.2 ng/ml,AFC<5,using PPOS program.Group B2 was that age was less than 35 years old,AMH<1.2 ng/ml,AFC<5,using antagonist program.The general information,ovulation induction and laboratory indicators were compared.Results In different age groups,there were no statistically significant differences of two ovulation induction programs in age,years of infertility,body mass index,basal antral follicle counting(AFC),and anti-Müllerian hormone(AMH)(P>0.05).There was no significant difference in the number of eggs obtained,2 PN,and available embryos between A1 and A2 group(P>0.05).The numbers of Gn days,total Gn and D3 high-quality embryos,and D3 high-quality embryos rate in A1 group were slightly higher than those in A2 group with no statistically significant difference.The numbers of Gn days,total Gn and D3 high-quality embryos,and D3 high-quality embryos rate in B1 group were slightly higher than those in B2 group with no statistically significant difference(P>0.05).The numbers of eggs obtained,2 PN and available embryos in B2 group were higher than that of group B1 with no statistically significant difference(P>0.05).Conclusion The ovulation stimulation program under high progesterone state during follicular phase is applied to expected POR patients aged≥35 years old that satisfactory clinical results could be obtained.It also c

关 键 词：卵巢低反应 卵泡期高孕激素状态下促排卵方案 拮抗剂方案 波塞冬分类 

分 类 号：R714.12[医药卫生—妇产科学]