卵泡期长效长方案改善反复种植失败患者IVF/ICSI的临床结局  

Long-acting GnRH agonist long protocol in follicular phase could improve IVF/ICSI outcomes of recurrent implantation failure

作　　者：李文澍 包洪初 张伟[2] 赵慧珊 刘雪梅[1,2] Li Wenshu;Bao Hongchu;Zhang Wei(Qingdao University,Qingdao 266071;Reproductive Medicine Center,Yantai Yuhuangding Hospital,Affiliated Hospital of Qingdao University,Yantai 266000)

机构地区：[1]青岛大学,青岛266071 [2]青岛大学附属烟台毓璜顶医院生殖医学中心,烟台266000

出　　处：《现代妇产科进展》2021年第9期670-674,共5页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金(No:81601276);烟台市科技计划项目(No:2020YD006)。

摘　　要：目的:探讨卵泡期长效长方案在反复种植失败(RIF)患者体外受精(IVF)/卵胞浆内单精子注射(ICSI)助孕过程中的临床应用。方法:回顾分析2015年6月至2020年6月在青岛大学附属烟台毓璜顶医院生殖医学中心再次行IVF/ICSI助孕的730例RIF患者的临床资料。根据促排卵方案将患者分为拮抗剂方案、长方案和卵泡期长效长方案三组,比较各组患者的临床结局。结果:卵泡期长效长方案与长方案和拮抗剂方案相比,促性腺激素(Gn)总量和持续时间显著增加(P<0.001),Gn启动日和人绒毛膜促性腺激素(HCG)日血清促黄体生成素(LH)水平和雌二醇(E2)水平显著降低(P<0.001),患者IVF/ICSI后的胚胎种植率、临床妊娠率和活产率显著提高(40.60%、30.00%、30.42%,P=0.036;55.55%、39.56%、43.39%,P=0.042;51.11%、36.81%、33.79%,P=0.016)。结论:卵泡期长效长方案与长方案及拮抗剂方案相比,能改善RIF患者IVF/ICSI的临床结局。Objective:To investigate the effect of long-acting gonadotrophin-releasing hormone agonist(GnRH-a)long protocol in follicular phase on IVF/ICSI outcomes of patients with recurrent implantation failure(RIF).Methods:This retrospective cohort study was carried out from June 2015 to June 2020.730 patients with RIF who underwent the IVF/ICSI were enrolled.The patients were classified by the ovarian stimulation protocols.The clinical outcomes of IVF/ICSI were compared in each group.Results:These RIF patients who received long-acting GnRHa long protocol had significantly higher clinical pregnancy rates(55.55%,39.56%,43.39%;P=0.042),implantation rates(40.60%,30.00%,30.42%;P=0.036)and live birth rates(51.11%,36.81%,33.79%;P=0.016)compared with short-acting GnRH-a long protocol and GnRH antagonist protocol.They also had significantly higher duration of stimulation and total dose of gonadotrophin(Gn)than other groups(P<0.001).However,serum levels of luteinizing hormone(LH)and estradiol(E2)on human chorionic gonadotropin(HCG)day were significantly lower among women who received long-acting GnRH-a(P<0.001).Conclusions:Long-acting GnRH-a long protocol in follicular phase could improve IVF/ICSI outcomes of patients with RIF compared with short-acting GnRHa long protocol and GnRH antagonist protocol.

关 键 词：反复种植失败 卵泡期长效长方案 临床妊娠率 胚胎种植率 活产率 

分 类 号：R715.2[医药卫生—妇产科学]