重组生长激素预处理对卵巢低反应患者促排卵结局及子宫内膜容受性的影响  

Effects of recombinant growth hormone pretreatment on IVF outcome and endometrial receptivity in patients with poor ovarian response

作　　者：杨元菁 施晓鋆 王聪[2] YANG Yuan-jing;SHI Xiao-yun;WANG Cong(Guizhou Medical University,Guiyang 550004;Guiyang Maternal and Child Health Care Hospital,Guiyang 550003)

机构地区：[1]贵州医科大学,贵阳550004 [2]贵阳市妇幼保健院,贵阳550003

出　　处：《生殖医学杂志》2022年第11期1545-1553,共9页Journal of Reproductive Medicine

摘　　要：目的 探讨重组生长激素(r-GH)预处理对卵巢低反应(POR)患者促排卵结局及子宫内膜容受性的影响,为临床上r-GH在POR患者中的应用提供参考。方法 选取2020年10月至2021年12月就诊于贵阳市妇幼保健院生殖中心的75例POR患者为研究对象,随机分为对照组(25例)及预处理组(给予r-GH预处理,50例),比较两组患者的一般资料、促排卵和胚胎发育指标,以及预处理组r-GH预处理前后的自身对照情况。又将75例患者按照年龄不同分为<35岁组及≥35岁组,比较不同年龄组中对照组和预处理组的促排卵结局及预处理组的自身对照情况。此外,对预处理组中的10例患者在预处理前后分别取样子宫内膜组织,采用免疫组化法和qRT-PCR法检测同源框基因A10(HOXA10)的蛋白及mRNA表达水平。结果 对照组和预处理组的年龄、不孕年限、体质量指数(BMI)、基础性激素水平比较均无显著性差异(P>0.05)。两组患者的Gn天数、基础窦卵泡计数(AFC)、HCG日E及内膜厚度、2PN率及优质胚胎率比较均无显著性差异(P>0.05);预处理组Gn总量显著低于对照组,获卵数及MⅡ卵数显著高于对照组(P均<0.05)。预处理组的自身对照比较中,进行预处理的本周期中Gn总量、Gn天数显著低于未行预处理的上一周期,获卵数、MⅡ卵数及优质胚胎率显著高于上一周期(P均<0.05)。<35岁患者中对照组和预处理组的促排卵及胚胎发育指标均无显著性差异(P>0.05);预处理组的自身对照比较中,本周期的Gn天数显著低于上一周期,获卵数及MⅡ卵数显著高于上一周期(P均<0.05)。≥35岁患者中,预处理组的Gn天数显著低于对照组,优质胚胎率显著高于对照组(P<0.05);预处理组的自身对照比较中,本周期的Gn天数显著低于上一周期,获卵数、MⅡ卵数及优质胚胎率显著高于上一周期(P均<0.05)。r-GH预处理后子宫内膜中HOXA10蛋白及mRNA表达显著高于预处理前(P<0.05)。结论 �Objective:To explore the effect of recombinant growth hormone(r-GH)pretreatment on the outcome of controlled ovulation induction and endometrial receptivity in patients with poor ovarian response(POR).Methods:Seventy-five POR patients who were treated in the Reproductive Center of Guiyang Maternal and Child Health Care Hospital from October 2020 to December 2021 and were selected as research object.They were randomly divided into control group(n=25)and pretreatment group(pretreatment with r-GH,n=50).The general data,ovulation induction outcomes and embryo development index were compared between groups.Then 75 patients were further divided into<35 years old group and≥35 years old group.The results of ovulation induction in control group and pretreatment group and the self-control of pretreatment group were compared in different age groups.In addition,the endometria of 10 patients in the r-GH pretreatment group before and after pretreatment was collected for determine the expression of homeobox A10(HOXA10)by immunohistochemistry and qRT-PCR.Results:There were no significant differences in age,infertility years,body mass index(BMI)and basic sex hormone levels between the control group and the pretreatment group(P<0.05).There were no significant differences in Gn days,basal antral follicle count(AFC),E 2 and endometrial thickness on HCG day,2PN rate and high-quality embryo rate between the two groups(P>0.05).The total amount of Gn used in the pretreatment group was significantly less than that in the control group,and the number of oocytes retrieved and MⅡoocytes was significantly more than that in the control group(P<0.05).In the self-control comparison of the pretreatment group,the total doses and days of Gn used in this cycle with pretreatment were significantly less than those in previous cycle without pretreatment,and the number of oocytes retrieved,MⅡoocytes and high-quality embryo rate were significantly more than those in previous cycle(P<0.05).In patients<35 years old,there were no significant differen

关 键 词：卵巢低反应 促排卵 重组生长激素 同源框基因A10 子宫内膜容受性 

分 类 号：R711.6[医药卫生—妇产科学]