长效长方案促排卵前采取高纯度人尿促性素预处理的临床分析  

Clinical analysis of high-purity human postmenopausal gonadotropin pretreatment before ovarian stimulation in long-acting protocol

作　　者：包莉莉 杨波[1] 王冬雪[1] 李冬秀 Bao Lili;Yang Bo;Wang Dongxue;Li Dongxiu(Department of Reproductive Medicine,The 980th Hospital of PLA Joint Logistics Support Force,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]中国人民解放军联勤保障部队第九八零医院生殖医学中心,石家庄050000

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第2期152-158,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：河北省卫生计生委青年科技课题(20170947)。

摘　　要：目的探讨在长效长方案促排卵前,采取高纯度人尿促性素(HP-hMG)预处理,对接受体外受精/卵胞浆内单精子注射(IVF/ICSI)-胚胎移植(ET)助孕的不孕女性临床妊娠结局的影响。方法选择2018年1月至2019年8月,于中国人民解放军联勤保障部队第九八零医院生殖医学中心进行IVF/ICSI-ET助孕,并采用长效长方案促排卵的171例卵巢储备功能正常的不孕女性为研究对象。回顾性分析其临床病例资料。根据启动促性腺激素(Gn)前是否采用HP-hMG预处理,将其分为研究组(n=102,采用HP-hMG进行预处理)与对照组(n=69,未进行预处理)。对2组受试者的一般临床资料、接受IVF/ICSI-ET助孕中相关临床指标、ET相关指标、妊娠结局及助孕相关不良反应发生率等,采用独立样本t检验及χ^(2)检验进行统计学比较。本研究经本院伦理委员会批准(审批文号:2020-KY-129),所有受试者均签署知情同意书。结果①2组受试者年龄、人体质量指数(BMI)、原发不孕者所占比例、不孕年限、基础窦卵泡计数(AFC),以及基础血清激素,包括卵泡刺激素(FSH)、促黄体激素(LH)、雌二醇及孕酮水平比较,差异均无统计学意义(P>0.05)。②2组受试者降调节后血清FSH、LH、雌二醇及孕酮水平,Gn启动日血清FSH及雌二醇水平,Gn使用时间及剂量,人绒毛膜促性腺激素(hCG)日血清LH、雌二醇及孕酮水平,以及移植日子宫内膜厚度比较,差异亦均无统计学意义(P>0.05)。研究组受试者Gn启动日血清LH水平为(1.27±0.81)IU/L,显著高于对照组的(0.46±0.21)IU/L,并且差异有统计学意义(t=-8.115、P<0.001)。③2组受试者的获卵数、获卵率、MⅡ卵率、正常受精率、优质胚胎率、鲜胚移植率、移植胚胎数、IVF与ICSI比值(IVF/ICSI)、临床妊娠率及自然流产率比较,差异均无统计学意义(P>0.05)。研究组中、重度卵巢过度刺激综合征(OHSS)及卵巢低反应发生率均为0,显著低于对照组的4.Objective To explore impacts of pretreatment with high-purity human postmenopausal gonadotropin(HP-hMG)before ovarian stimulation in long-acting protocol on clinical pregnancy outcome of sterile females who took in vitro fertilization/intracytoplasmic sperm injection(IVF/ISCI)-embryo transfer(ET).Methods A total of 171 sterile females with normal ovarian reserve to whom long-acting IVF/ICSI-ET program for assisted reproduction in Department of Reproductive Medicine of the 980th Hospital of PLA Joint Logistics Support Force from January 2018 to August 2019,were selected as research subjects.Their clinical case data were retrospectively analyzed.According to whether pretreated with HP-hMG before officially launching gonadotropin(Gn)or not,they were divided into study group(n=102,pretreated with HP-hMG)and control group(n=69,without pretreatment).The general clinical data,relevant clinical indicators during IVF/ICSI-ET for assisted reproduction,related indicators of ET,pregnancy outcome and the incidence of adverse reactions related to assisted reproduction of two groups were statistically compared by independent-samples t test and chi-square test.This study was approved by the Ethics Committee of our hospital(Approval No.2020-KY-129),and all subjects signed the informed consents.Results①There were no significant differences in age,body mass index(BMI),proportion of primary infertility,duration of infertility,basal antral follicle count(AFC)and basal serum hormone levels,including follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol and progesterone between two groups(P>0.05).②There were no significant differences in serum FSH,LH,estradiol and progesterone levels after down-regulation,serum FSH and estradiol levels on Gn start-up day,the usage days and dose of Gn,serum LH,estradiol and progesterone levels on human chorionic gonadotrophin(hCG)day,and endometrial thickness on transplantation day between two groups(P>0.05).The serum LH level on Gn start-up day of study group was(1.27±0.81)IU/L,which

关 键 词：促生育素类 卵巢过度刺激综合征 控制性超排卵 受精 体外 精子注射 细胞质内 妊娠结局 女(雌)性 

分 类 号：R714.8[医药卫生—妇产科学]