89例卵巢储备正常不孕症患者首次早卵泡期长方案助孕失败改行拮抗剂方案疗效观察  

Observation on the efficacy of 89 cases of infertility patients with normal ovarian reserve who failed the first early follicular phase long-term program and switched to antagonist program

作　　者：艾海权[1] 刘晨 范思杨 腊晓琳[1] 韩锐[3] AI Haiquan;LIU Chen;FAN Siyang;LA Xiaolin;HAN Rui(Department of Reproductive Medicine,Reproductive Medicine Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Xinjiang Medical University,Urumqi 830054,China;Department of Prenatal Diagnosis,Reproductive Medicine Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院生殖医学中心生殖医学科,乌鲁木齐830054 [2]新疆医科大学,乌鲁木齐830054 [3]新疆医科大学第一附属医院生殖医学中心产前诊断科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2022年第8期848-851,857,共5页Journal of Xinjiang Medical University

基　　金：省部共建国家重点实验室开放课题(SKL-HIDCA-2020-JZ10)。

摘　　要：目的 探讨卵巢储备正常不孕症患者首次早卵泡期长方案助孕失败再次助孕时改用拮抗剂方案助孕效果。方法 回顾性分析2020年3月至2021年9月在新疆医科大学第一附属医院行助孕治疗的卵巢储备正常且首次早卵泡期长方案助孕失败后改行拮抗剂方案助孕患者89例178新鲜周期临床资料,按照促排卵方案分为早卵泡期长方案组(A组)和拮抗剂方案组(B组),采用自身前后对照研究比较两种方案促排卵情况及临床结局。结果 促排卵情况方面:A组患者平均促性腺激素(Gn)天数及平均Gn总量均高于B组,组间差异有统计学意义(P<0.05),人绒毛膜促性腺激素(HCG)日≥14 mm卵泡数及HCG日内膜厚度A组略高于B组,差异无统计学意义,HCG日雌二醇(E2)水平及HCG日促黄体生成素(LH)水平A组明显低于B组,组间差异有统计学意义(P<0.05)。实验室及临床结局方面:两组的获卵数基本一致,但两次分裂中期的成熟二级卵母细胞(MII卵)数、双原核(2PN)数、第3天(D3)可用胚胎数、D3优质胚胎数、可用囊胚形成率及临床妊娠率A组均明显低于B组,周期取消率B组低于A组,组间差异有统计学意义(P<0.05)。结论 对于前次早卵泡期长方案促排助孕失败卵巢储备正常患者改行拮抗剂方案可以减少Gn天数并降低Gn总量,同时可获得较好的实验室及临床结局,是理想的卵巢刺激替代方案。Objective To einvestigate the effects of switching to antagonist regimen in patients with normal ovarian reserve when the first failure adopt long protocol in early follicular phase.Methods A total of 89 patients with 178 cycles of fresh cycle who switched to antagonist protocol again because of first failure adopt long protocol in early follicular phase from March 2020 to September 2021 were analyzed retrospectively,the patients were divided into long protocol in early follicular phase group(group A) and the antagonist protocol group(group B).The Parameters of ovulation induction process,laboratory and clinical outcomes of the two groups were compared in a self-controlled study.Results In terms of ovulation induction,the average days of Gn and totals of Gn in group A were higher than group B,there were statistically significant(P < 0.05).The number of follicles ≥ 14mm and the endometrial thickness on HCG day were slightly higher in group A than in group B,and there were no statistically significant differences.The level of E2and the level of LH on HCG day in group A were significantly lower than those in group B,and the difference among group A and group B showed statistically significance(P < 0.05).In terms of laboratory and clinical outcomes,the number of ova obtained in two groups was basically the same,however,compared with the number of MII,2PN,D3 available embryos,D3 superior quality embryos,the ratio of available blastocyst formation and clinical pregnancy,A group was significantly lower.The cycle cancellation ratein group B was lower than group A,and the difference between the groups were statistically significant(P < 0.05).Conclusion For patients with normal ovarian reserve who failed the previous long protocol in early follicular phase,switching to the antagonist regimen can reduce the number of Gn days and the total amount of Gn,and it has better laboratory and clinical outcomes as an ideal alternative protocol.

关 键 词：拮抗剂方案 早卵泡期长方案 卵巢储备正常 

分 类 号：R71[医药卫生—妇产科学]