卵泡期长效长方案中HMG预处理对体外受精-胚胎移植结局的影响  

Effect of HMG pretreatment on IVF-ET outcomes with follicular phase long-acting long protocol

作　　者：徐小娅 谭丽[1] XU Xiao-ya;TAN Li(Reproductive Medical Center,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014)

机构地区：[1]郑州大学第二附属医院生殖中心,郑州450014

出　　处：《生殖医学杂志》2021年第5期633-637,共5页Journal of Reproductive Medicine

基　　金：郑州市科技惠民计划项目(2019KJHM0009)。

摘　　要：目的探讨在IVF/ICSI-ET过程中,卵泡期长效长方案促排卵前给予人绝经期促性腺激素(HMG)预处理对临床结局的影响。方法回顾性分析2017年3月至2019年12月在我院生殖医学中心接受IVF/ICSI-ET治疗、采用卵泡期长效长方案降调节后出现垂体抑制过深的362例不孕患者的临床资料,根据促排卵前是否添加HMG分为HMG组(152例)及对照组(210例),分别比较两组患者的基础资料、促排卵指标及妊娠结局。结果HMG组与对照组患者的基础资料比较无显著性差异(P>0.05);HMG组促性腺激素(Gn)天数[(10.57±1.63)d vs.(11.40±1.78)d]、Gn总量[(2513.65±658.35)U vs.(2740.65±672.77)U]、获卵数[(11.24±4.24)枚vs.(12.17±4.11)枚]、HCG日E 2水平[(9966.48±5602.58)pmol/L vs.(11318.65±6320.70)pmol/L]显著低于对照组(P<0.05),MⅡ卵率[95.96%vs.92.60%]、优胚率[57.69%vs.53.48%]显著高于对照组(P<0.05);HMG组的正常受精率、胚胎种植率、临床妊娠率、活产率略高于对照组,流产率、早产率、中重度卵巢过度刺激综合征(OHSS)发生率略低于对照组,但尚无显著性差异(P>0.05)。结论对于应用卵泡期长效长方案降调节后出现垂体过度抑制的卵巢储备正常患者,早期添加HMG预处理可以减少Gn用量及使用时间,提高卵母细胞及胚胎质量,可能改善妊娠结局。Objective:To investigate the effect of pretreatment with human menopausal gonadotropin(HMG)before ovulation induction with follicular phase long-acting long protocol on clinical outcomes of IVF/ICSI-ET.Methods:The clinical data of 362 patients who received IVF/ICSI-ET treatment with follicular phase long-acting long protocol in the reproductive center of our hospital from March 2017 to December 2019 were retrospectively analyzed.According to whether to use HMG before ovulation induction,the patients were divided into HMG group(n=152)and control group(n=210),the basic data,ovulation induction indicators and pregnancy outcomes of the two groups were compared.Results:There was no significant difference in the basic data between the HMG group and the control group(P>0.05).The gonadotropin(Gn)days[(10.57±1.63)days vs.(11.40±1.78)days],dosages of Gn[(2513.65±658.35)U vs.(2740.65±672.77)U],the number of oocytes retrieved[(11.24±4.24)vs.(12.17±4.11)],the E 2 level on HCG days[(9966.48±5602.58)pmol/L vs.(11318.65±6320.70)pmol/L]in HMG group were significantly lower than those in the control group(P<0.05),while MII oocyte rate[95.96%vs.92.60%]and the excellent embryo rate[57.69%vs.53.48%]were significantly higher than those in the control group(P<0.05).The normal fertilization rate,embryo implantation rate,clinical pregnancy rate and live birth rate in HMG group were higher than those of control group,while the abortion rate,premature birth rate and the incidence of moderate to severe ovarian hyperstimulation syndrome(OHSS)were lower than those of control group,but the differences were not significant(P>0.05).Conclusions:For patients with normal ovarian reserve,who had excessive pituitary suppression after long-term follicular down-regulation,the early addition of HMG can reduce the dosages and days of Gn,increase the quality of oocytes and embryos,and improve the pregnancy outcomes.

关 键 词：人绝经期促性腺激素 控制性促排卵 垂体抑制 临床妊娠率 

分 类 号：R711.6[医药卫生—妇产科学]