PCOS患者COH中不同时长Gn临床妊娠结局及Gn时间延长的相关因素分析  

Analysis of the relative factors of clinical pregnancy outcomes and prolonged Gn duration of COH patients with different Gn duration

作　　者：刘铃铃 刘振贤 程虹[1] LIU Lingling;LIU Zhenxian;CHENG Hong(Haikou Hospital Affiliated to Xiangya Medical College of Central South University,Haikou,Hainan Province,570208)

机构地区：[1]中南大学湘雅医学院附属海口医院妇产科,海口570208

出　　处：《中国计划生育学杂志》2020年第9期1462-1466,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨多囊卵巢综合征(PCOS)患者在体外受精胚胎移植(IVF ET)控制性超排卵技术(COH)中应用不同时长促性腺激素(Gn)的妊娠结局及影响Gn时间延长可能因素。方法:收集2015年1月-2019年1月因PCOS不孕采用早卵泡期长效长方案治疗患者85例,根据Gn使用时长分组,≤9d 17例为短时长组,10~15d 49例为中时长组,>15d 19例高时长组。比较各组的临床特征及治疗结果,采用单因素和logistic多因素回归分析Gn时间延长影响因素。结果:3组年龄、不孕年限、基础雌二醇、基础促黄体生成素(LH)、降调节时间、启动剂量比较均无差异(P>0.05),但3组间基础卵泡刺激素(FSH)、Gn启动日FSH和LH有差异(P<0.05);3组间周期取消率、获卵数、可利用胚胎数、移植胚胎数及新鲜胚胎移植率,以及发生中重度OHSS比例、临床妊娠率、早期流产率及异位妊娠率等均无差异(均P>0.05)。多因素回归分析显示,体质指数(BMI)、基础FSH高水平为Gn时间延长的危险因素(P<0.05),启动日FSH及LH复常是Gn时间延长的保护性因素(P<0.05)。结论:PCOS伴不孕症患者在IVF ET过程中Gn使用时间长短并非影响临床妊娠结局的直接因素,基础BMI及FSH过高、降调节后Gn启动日FHS及LH水平过低可能是影响Gn使用时长的主要因素。Objective:To explore the pregnancy outcomes of women with polycystic ovary syndrome(PCOS)used different duration of gonadotropin(Gn)in prolonged Gn duration in controlled hyperovulation(COH)technique of IVF ET,and to study the influencing factors of prolonged Gn duration.Methods:85 infertility women because of PCOS who had given long acting and long term treatment in early follicular phase were collected from January 2015 to January 2019,and they were divided into group A(17 women with Gn promotion time≤9d),group B(49 women with 10d≤Gn promotion time≤15d),and group C(19 women with Gn stimulus time≥15d Gn promotion time≤9d)according to the duration of Gn used.The clinical characteristics and treatment results of women were compared among the three groups.The related factors of GN duration extension were analyze by univariate and Logistic multivariate regression analysis.Results:There were no significant different in age,infertility years,basic E 2 level,basic LH level,down regulation time,and starting Gn dose of women among the three groups(P>0.05),but there were significant different in the levels of basic FSH,FSH and LH on the startup day of women among the three groups(P<0.05).There were no significant different in the rate of cycle cancellation,oocytes retrieved number,available embryos number,transplanted embryo number,and the rates of fresh embryo transfer,moderate to severe OHSS,clinical pregnancy,early abortion,and ectopic pregnancy of women among the three groups(P>0.05).Logistic multivariate regression analysis showed that the high levels of BMI and basic FSH were the risk factors of prolonged Gn time(P<0.05),while the levels of FSH and LH reactivation on the start day were protective factors of extended Gn time(P<0.05).Conclusion:The duration of Gn used during IVF ET of infertility women because of PCOS is not the direct factor affecting clinical pregnancy outcomes.The excessively high basic BMI value and FSH level,and the low FSH and LH levels on the Gn start up day after down regulation may

关 键 词：多囊卵巢综合征 体外受精胚胎移植 控制性超排卵技术 促性腺激素 使用时间 临床结局 

分 类 号：R714.8[医药卫生—妇产科学] R711.75[医药卫生—临床医学]