PPOS方案与拮抗剂方案对卵巢低反应患者IVF-ET助孕结果的影响  

Effect of PPOs regimen and antagonist on the outcome of IVF-ET in patients with poor ovarian response

作　　者：李佳霖 孙永[2] 张硕 Li Jialin;Sun Yong;Zhang Shuo(Department of Reproduction and Genetics,Hospital for Reproductive Medicine Affiliated to Shandong University,Jinan 250021,China;Department of Reproductive Medicine,Linyi People’s Hospital,Linyi 276000,China)

机构地区：[1]山东大学附属生殖医院生殖遗传科,济南250021 [2]山东省临沂市人民医院生殖医学科,276000

出　　处：《中华内分泌外科杂志》2021年第6期657-660,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的比较高孕激素状态下促排卵(PPOS)方案与拮抗剂方案对卵巢低反应(POR)患者体外受精-胚胎移植(IVF-ET)助孕结果的影响。方法选取山东大学附属生殖医院行IVF-ET助孕的208例POR患者为研究对象,按随机数字表法随机分为观察组和对照组,各104例。观察组患者行PPOS方案,对照组患者行拮抗剂方案,比较两组人绒毛膜促性腺激素(HCG)日激素水平[促卵泡素(FSH)、促黄体素(LH)、孕酮(P)、雌二醇(E2)]、助孕结局(促性腺激素(Gn)用药总量、Gn用药天数、获卵数、可移植胚胎数、周期取消率、卵母细胞成熟率)及妊娠结局(扳机日子宫内膜厚度、移植胚胎数、胚胎种植率、临床妊娠率、流产率、活产率)。结果观察组HCG日血清LH水平明显低于对照组[(2.88±2.56)vs(4.51±4.26),P<0.05],两组患者治疗后HCG日激素水平(FSH、P、E2)比较差异无统计学意义(P>0.05)。观察组治疗后Gn用药总量(2210.42±766.88 vs 1747.01±764.98)(IU)、Gn用药天数(10.88±3.21 vs 9.12±3.14)d、卵母细胞成熟率(66.35%vs 51.92%)明显高于对照组,周期取消率明显低于对照组(P<0.05);治疗后两组获卵数、可移植胚胎数比较差异无统计学意义(P>0.05)。观察组治疗后移植胚胎数(1.21±0.61 vs 0.94±0.41)枚、胚胎种植率[(21.43±4.30)%vs(20.48±3.89)%],活产率明显高于对照组(84.62%vs 70.19%),而流产率明显低于对照组(15.38%vs 29.81%)(P<0.05);治疗后两组扳机日子宫内膜厚度、临床妊娠率比较差异无统计学意义(P>0.05)。结论PPOS方案较拮抗剂方案治疗POR患者临床疗效更加明显,简化促排卵过程同时,增强卵巢对促排药物敏感度,安全方便、经济可行,值得临床推广。Objective To compare the effects of high progesterone induced ovulation(PPOs)and antagonist on the outcome of in vitro fertilization embryo transfer(IVF-ET)in patients with poor ovarian response(POR).Methods 208 POR patients who underwent IVF-ET in our hospital were selected as the research objects,and were randomly divided into observation group and control group according to the random number table method,with 104 cases in each.The observation group were treated with PPOs regimen,while the control group were treated with antagonist regimen.The daily hormone levels of human chorionic gonadotropin(hCG)[follicle stimulating hormone(FSH),luteinizing hormone(LH),progesterone(P),estradiol(E2)],pregnancy outcome[total amount of gonadotropin(GN),days of GN administration,number of oocytes retrieved,number of transferred embryos,cycle cancellation rate,oocyte maturation rate]and pregnancy outcomes were compared between the two groups(endometrial thickness on trigger day,number of transferred embryos,implantation rate,pregnancy rate,clinical pregnancy rate,abortion rate,live yield).Results The serum LH level in the observation group was significantly lower than that in the control group(P<0.05),and there was no difference in HCG hormone levels(FSH,P,E2)between the two groups after treatment(P>0.05).The total amount of Gn medication,Gn medication days,and oocyte maturation rate of the observation group after treatment were significantly higher than those of the control group,and the cycle cancellation rate was significantly lower than that of the control group(P<0.05);The number of transferred embryos,embryo implantation rate,and live birth rate in the observation group after treatment were significantly higher than those in the control group,while the abortion rate was significantly lower than that in the control group(P<0.05);There was no significant difference in the endometrial thickness and clinical pregnancy rate on trigger days between the two groups(P>0.05).Conclusions Compared with the antagonist regimen,the PPOS

关 键 词：高孕激素状态下促排卵方案 拮抗剂 卵巢低反应 体外受精-胚胎移植 

分 类 号：R588.6[医药卫生—内分泌]