IVF-ET中用EFLL、MLSL、GnRH-ant促排卵的不孕症波塞冬标准组3 POR患者排卵及妊娠结果对比观察  

Comparative observation of ovulation and pregnancy results of poor ovarian responders with infertile POSEIDON group 3 treated with EFLL,MLSL,and GnRH-ant to induce ovulation in IVF-ET

作　　者：祁玉娟[1,2] 严晓南[1,2] 曹义娟 刘颖[1,2] 谭小方[3] QI Yujuan;YAN Xiaonan;CAO Yijuan;LIU Yin;TAN Xiaofang(Clinical Center of Reproductive Medicine,Xuzhou Central Hospital,Nantong 221000,China;不详)

机构地区：[1]徐州市中心医院生殖中心,江苏徐州221000 [2]东南大学生殖医学遗传研究所 [3]南通市妇幼保健院

出　　处：《山东医药》2022年第6期25-29,共5页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81571405);江苏省自然科学基金资助项目(BK20161169);徐州市科学技术社会发展项目(KC20092)。

摘　　要：目的比较体外受精-胚胎移植(IVF-ET)中分别采用长效长方案(Early-follicular phase long-acting GnRH agonist long protocol,EFLL)、短效长方案(Mid-luteal phase short-acting,MLSL)及拮抗剂方案(GnRH agonist long protocol,GnRH-ant)促排卵的不孕症波塞冬(Patient-Oriented Strategies Encompassing Individualized Oocyte Num⁃ber,POSEIDON)标准组3的卵巢低反应(Poor ovarian responders,POR)患者的排卵及妊娠结果。方法不孕症波POSEIDON标准组3POR患者248例,共276个IVF周期,分为EFLL 34个周期(EFLL组)、MLSL 69个周期(MLSL组)及GnRH-ant 173个周期(GnRH-ant组)。EFLL组、MLSL组和GnRH-ant分别采用EFLL、MFLL、GnRH-ant促排卵方案治疗,后续进行IVF-ET移植。观察并记录三组促排卵情况(获卵数、成熟MII卵数)及妊娠结果(受精率、D3可移植胚胎数、优质胚胎数及全胚冷冻率、胚胎种植率、单周期临床妊娠率、单周期活产率及流产率)。结果与MLSL、GnRH-ant组比较,促排治疗后EFLL组获卵数、成熟MII卵数多(P均<0.05)。与MLSL、GnRH-ant组比较,EFLL组D3可移植胚胎数、优质胚胎数多,全胚冷冻率低(P均<0.05)。与MLSL、GnRH-ant组比较,EFLL组单周期临床妊娠率、单周期活产率高(P均<0.05)。结论采用EFLL治疗后POSEIDON标准组3患者促排卵效果好,IVF-ET妊娠结果较好。与MLSL、GnRH-ant比较,采用EFLL治疗的POSEIDON标准组3患者获卵数、成熟MII卵数均较高,IVF-ET妊娠结果较好。Objective To compare the clinical effects of early-follicular phase long-acting GnRH agonist long proto⁃col(EFLL),mid-luteal phase short-acting GnRH agonist long protocol(MLSL),and GnRH antagonist protocol(GnRH-ant)on in vitro fertilization-embryo transfer(IVF/ET)outcome in poor ovarian responders(POR)with Patient-Oriented Strategies Encompassing Individualized Oocyte Number(POSEIDON)group 3.Methods Totally 248 cases of POSEI⁃DON group 3 patients were selected.A total of 276 IVF cycles were divided into 34 EFLL cycles(EFLL group),69 MLSL cycles(MLSL group)and 173 GnRH-ant cycles(GnRH-ant group).In the EFLL group,MLSL group and GnRH-ant,we used the EFLL,MFLL,and GnRH-ant to induce the ovulation,respectively,followed by IVF-ET.The ovulation induc⁃tion(the number of oocyte retrieved and the number of MII oocytes)and the pregnancy results(fertilization rate,D3 trans⁃ferable embryos,high-quality embryos and whole embryo freezing rate,embryo implantation rate,the clinical pregnancy rate per cycle,the live birth rate per cycle,and abortion rate)of three groups were observed and recorded.Results Compared with the MLSL and GnRH-ant groups,the number of oocyte retrieved and the number of MII oocytes increased in the EFLL group(both P<0.05).Compared with the MLSL and GnRH-ant groups,the number of D3 transferable embryos and the number of high-quality embryos increased,and the whole embryo freezing rate decreased in the EFLL group(all P<0.05).The clinical pregnancy rate per cycle and the live birth rate per cycle in the EFLL group were higher than those in the other two groups(all P<0.05).Conclusions For the patients of POSEIDON group 3,EFLL can obtain satisfacto⁃ry COS results and better pregnancy outcomes.Compared with MLSL and GnRH-ant treatments,patients treated with EFLL can obtain more oocytes and MII oocytes,and have better pregnancy outcomes.

关 键 词：卵巢低反应 波塞冬标准 促排卵治疗 长效长方案 短效长方案 拮抗剂方案 体外受精—胚胎移植 妊娠结果 

分 类 号：R737[医药卫生—肿瘤]