超重/肥胖患者应用拮抗剂方案添加重组人黄体生成素的临床效果  

Clinical effects of adding recombinant human LH in GnRH antagonist protocol in patients with overweight/obesity

作　　者：朱光丽 韩潇 张玉婷 赵芳 张艳萍 宋娜 石占荣 吕玉珍 ZHU Guang-li;HAN Xiao;ZHANG Yu-ting;ZHAO Fang;ZHANG Yan-ping;SONG Na;SHI Zhan-rong;L Yu-zhen(The Reproductive Medicine Center,The Maternity&Child Health Care Hospital of Jiaozuo,Jiaozuo 454000)

机构地区：[1]焦作市妇幼保健院生殖医学科,焦作454000

出　　处：《生殖医学杂志》2022年第10期1380-1384,共5页Journal of Reproductive Medicine

基　　金：2019年度河南省医学科技攻关计划联合共建项目(LHGJ20191362)。

摘　　要：目的探讨GnRH拮抗剂方案中添加人重组黄体生成素(r-LH)在超重/肥胖的非多囊卵巢综合征(PCOS)患者IVF/ICSI-ET中的临床效果。方法回顾性队列研究2019年12月至2021年12月在本院生殖医学科行GnRH拮抗剂方案的208例非PCOS超重/肥胖患者的实验室指标及助孕结局。根据是否添加r-LH将患者分为两组:添加LH组(在添加GnRH拮抗剂日添加r-LH,n=100)和对照组(促排卵过程中未添加LH,n=108)。比较两组患者的基本资料、促排卵情况及临床妊娠结局。结果两组患者的年龄、不孕年限及体质量指数(BMI)等基础资料比较,差异均无统计学意义(P>0.05)。与对照组相比,添加LH组患者应用Gn时间[(10.45±1.45)d vs.(12.31±1.82)d]及Gn总量[(2831.56±345.71)U vs.(3365.47±273.68)U]显著减少(P<0.05),HCG日E 2水平[(9207.26±2478.94)pmol/L vs.(6908.15±2281.57)pmol/L]及LH水平[(2.65±1.53)U/L vs.(1.05±1.27)U/L]显著升高(P<0.05);添加LH组的平均获卵数[(7.53±2.61)vs.(5.08±2.75)]、2PN受精率(81.90%vs.74.68%)及卵裂期优胚率(54.99%vs.45.37%)均显著高于对照组(P<0.05);添加LH组的囊胚形成率及临床妊娠率虽高于对照组,但差异无统计学意义(P>0.05)。结论在IVF-ET周期GnRH拮抗剂方案促排卵过程中,超重/肥胖的非PCOS人群补充r-LH可改善患者胚胎质量。Objective:To investigate the clinical effects of adding recombinant human luteinizing hormone(r-LH)in GnRH antagonist protocol of IVF/ICSI-ET cycles in overweight/obese patients without polycystic ovary syndrome(PCOS).Methods:A retrospective cohort study was conducted to analyze the laboratory indices and pregnancy outcomes in 208 overweight/obese non-PCOS patients who underwent antagonist protocols in the reproductive medicine center of Jiaozuo Maternity&Child Healthcare Hospital from December 2019 to December 2021.Patients were divided into two groups according to whether r-LH was added or not:LH group(r-LH added on the day of antagonist application n=100),and control group(r-LH was not added during controlled ovary stimulation,n=108).The basic information,controlled ovary stimulation outcome and clinical pregnancy outcome of the two groups were compared.Results:There were no significant differences in the baseline data such as age,years of infertility and body mass index(BMI)between the two groups(P>0.05).Compared with that in control group,the Gn duration[(10.45±1.45)days vs.(12.31±1.82)days],total Gn doses[(2831.56±345.71)U vs.(3365.47±273.68)U]were significantly decreased,while E_(2) levels on HCG day[(9207.26±2478.94)pmol/L vs.(6908.15±2281.57)pmol/L]and LH levels[(2.65±1.53)U/L vs.(1.05±1.27)U/L]were significantly increased in the LH group(P<0.05).The mean number of oocytes retrieved[(7.53±2.61)vs.(5.08±2.75)],2PN fertilization rate(81.90%vs.74.68%),and high-quality embryo rate at cleavage stage(54.99%vs.45.37%)in the LH group were significantly higher than those in the control group(P<0.05).The blastocyst formation rate and clinical pregnancy rate in the LH group were slightly higher than those in the control group,but the difference was not significant(P>0.05).Conclusions:In IVF-ET cycle with GnRH antagonist protocol,r-LH supplementation can improve embryo quality in patients with overweight/obese.

关 键 词：体外受精-胚胎移植 拮抗剂方案 重组黄体生成素 体质量指数 助孕结局 

分 类 号：R711.6[医药卫生—妇产科学]