卵泡期长方案和氯米芬微刺激方案对高龄卵巢储备功能减退患者体外受精-胚胎移植技术助孕结局比较  

Comparison of pregnancy outcomes of in vitro fertilization-embryo transfer technique in elderly patients with reduced ovarian reserve between long-term follicular phase regimen and clomiphene microstimulation regimen

作　　者：李蓉[1] 曾玖芝[1] 曾琴[1] 刘伟信[1] LI Rong;ZENG Jiu-zhi;ZENG Qin;LIU Wei-xin(Reproductive Medical Center,Sichuan Provincial Hospital for Women and Children, Chengdu 610091,China)

机构地区：[1]四川省妇幼保健院生殖中心,四川成都610091

出　　处：《实用医院临床杂志》2022年第4期56-60,共5页Practical Journal of Clinical Medicine

基　　金：四川省妇幼保健院2018年院内科技创新基金普及应用项目。

摘　　要：目的探讨卵泡期长方案在35岁以上高龄、卵巢储备功能减退患者中的应用。方法回顾性分析35~45岁卵巢储备功能减退患者226例,接受卵泡期长方案的127个周期(A组)、氯米芬诱导的微刺激方案99个周期(B组),比较两组方案的临床结局。结果A组获卵数、正常受精数、正常卵裂数、可利用胚胎数、优质胚胎数较B组明显增多(P<0.05),B组中无可利用胚胎周期更高,差异有统计学意义(P<0.05);两组着床率、临床妊娠率、周期活产率比较差异无统计学意义(P>0.05);A组的检查总费用、药品费、总费用均高于B组(P<0.05);而B组因取卵周期均全胚冷冻,故实验室费用高于A组(P<0.05);A组正常卵裂率和可利用胚胎率较B组高(P<0.05),但单位效果的费用均低于B组(P<0.05)。结论卵泡期长方案可以作为高龄卵巢储备功能下降患者首次新鲜取卵的促排卵方案。Objective To investigate the application of long-term follicular phase regimen in women over 35 years old and with diminished ovarian reserve.Methods Clinical outcomes of 226 patientswith reduced ovarian reserve aged 35 to 45 years old were retrospectively analyzed.There were 127 cycles receiving a long-acting GnRH agonist follicular protocol(group A)and 99 cycles receivingclomiphene-inducedminimal ovarian stimulation protocol(group B).The clinical outcome were compared between the two protocols.Results The number of oocytes retrieved,the number of normal fertilization,the number of normal cleavage,the number of available embryos,and the number of high-quality embryos in the group A were significantly higher than those in the group B(P<0.05).Unavailable embryo cycle was higher in the group B,and the difference was statistically significant(P<0.05).There was no statistical significance in the implantation rate,clinical pregnancy rate,and live birth rate between the two groups(P>0.05).The total examination fee,drug fee and total fee of thegroup A were higher thanthose of thegroup B(P<0.05),whilethe laboratory cost of the group B was higher than that of the group A since the whole embryo was frozen during the oocyte retrieval cycle(P<0.05).Since the normal cleavage rate and available embryo rate in the group A were higher than those in the group B(P<0.05),the cost per unit effect was lower than that ofthe group B(P<0.05).Conclusion The long-acting GnRH agonist follicular protocol is the first choice of the ovarian stimulation protocol for the infertile patients in advanced age with diminished ovarian reserve.

关 键 词：高龄 卵巢储备功能减退 卵泡期长方案 氯米芬 微刺激方案 

分 类 号：R711.75[医药卫生—妇产科学]