不同拮抗剂在PCOS不孕症患者IVF/ICSI-ET拮抗剂方案助孕中的疗效  

Effects of cetrorelix versus ganirelix on the outcome of gonadotropin releasing hormone antagonist protocol in polycystic ovary syndrome patients

作　　者：水丽君 宗璐 张燕[1] 祝心怡 胡美红 栾红兵 汤文娟 郑圣霞 SHUI Lijun;ZONG Lu;ZHANG Yan;ZHU Xinyi;HU Meihong;LUAN Hongbin;TANG Wenjuan;ZHENG Shengxia(Center for Reproductive Medicine,Division of Life Sciences and Medicine,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230036,China)

机构地区：[1]中国科学技术大学附属第一医院安徽省立医院生殖中心,安徽合肥230036

出　　处：《皖南医学院学报》2022年第5期448-452,共5页Journal of Wannan Medical College

基　　金：安徽省自然科学基金面上项目(1808085MH242);中国科学技术大学教学研究重点项目(2021xjyxm091)。

摘　　要：目的:比较多囊卵巢综合症(PCOS)不孕患者在拮抗剂(GnRH-ant)方案体外受精胚胎移植(IVF/ICSI-ET)周期中使用不同拮抗剂药物的临床疗效。方法:回顾分析安徽省立医院生殖中心年龄≤35岁的应用GnRH-ant方案助孕的PCOS不孕患者182周期相关资料,根据使用GnRH-ant的药物不同分为西曲瑞克组115周期和国产仿制药加尼瑞克组67周期,比较两组患者基本资料、促排卵过程及临床妊娠结局。结果:国产仿制药加尼瑞克组优胚率、囊胚形成率高于西曲瑞克组(P<0.05)。两组患者基本资料、其他促排卵过程及助孕结局相关指标差异均无统计学意义(P>0.05)。在进行鲜胚移植Day3分裂胚(D3)的43个周期中,两组种植率、临床妊娠率、多胎妊娠率、早期流产率、活产率差异均无统计学意义(P>0.05)。西曲瑞克与国产仿制药加尼瑞克在PCOS伴胰岛素抵抗患者中促排卵过程及助孕结局差异均无统计学意义(P>0.05)。结论:在拮抗剂方案中使用国产仿制药加尼瑞克与西曲瑞克具有相似临床效果,HCG日LH升高发生率无显著差异,国产仿制药加尼瑞克组优胚率和囊胚形成率略高于西曲瑞克组,但两组均获得良好的临床妊娠结局。Objective:To evaluate the effects of cetrorelix and ganirelix in gonadotropin-releasing hormone antagonist(GnRH-ant) protocol and on clinical outcomes in vitro fertilization and embryo transfer/Intracytoplasmic sperm injection(IVF-ET/ICSI) cycles in infertile patients with polycystic ovary syndrome(PCOS).Methods:Clinical data were retrospectively analyzed in 182 patients(aged ≤35 years) with PCOS treated by GnRH-ant regimen in our hospital.The patients were divided into cetrorelix group(n=115) and ganirelix group(n=67),and compared regarding the characteristics of clinical baseline, ovarian stimulation and reproductive outcomes.Results:The embryos quality and blastocyst formation rate in the ganirelix group was higher than that of the cetrorelix group(P<0.05).The clinical outcomes with Day3(D3) fresh embryo transfer were similar in clinical pregnancy, miscarriage, and live birth rates between groups.There was no significant difference between cetrorelix and ganirelix in the process of ovulation induction and the outcome of assisted pregnancy in PCOS patients with insulin resistance.Conclusion:Cetrorelix and ganirelix can achieve comparable effects for preventing premature LH surges, and achieve similar clinical outcomes of GnRH-ant cycles in PCOS patients.

关 键 词：GNRH拮抗剂 西曲瑞克 加尼瑞克 体外受精-胚胎移植 

分 类 号：R711.75[医药卫生—妇产科学]