高龄低储备不孕女性促排卵方案回顾分析  

Retrospective Analysis of Ovulation Induction Cycles in Elderly Patients with Diminished Ovarian Reserve

作　　者：张旸[1] 刘浩[2] 任海颖[1] Zhang Yang;Liu Hao;Ren Haiying(Reproductive Center,Beijing Chaoyang Hospital Affiliated to Beijing Capital Medical University,Beijing 100020,China;不详)

机构地区：[1]北京市首都医科大学附属北京朝阳医院生殖中心,北京市100020 [2]北京市首都医科大学附属北京朝阳医院妇产科,北京市100020

出　　处：《中国病案》2022年第12期100-103,共4页Chinese Medical Record

摘　　要：目的比较不同剂量促性腺激素的促排卵方案,以探讨高龄卵巢低储备不孕女性适合的促排卵方案。方法回顾性分析2014年1月1日-2019年12月31日某三甲医院生殖中心≥40岁的高龄且基础窦卵泡数≤5个的229例患者第1周期促排卵方案结局,促排卵方案采取微刺激方案组66例,促性腺激素≤150IU/d和拮抗剂方案组163例,促性腺激素>150IU/d。拮抗剂方案组又分为常规剂量组88例,150<促性腺激素<300IU/d;高剂量组75例,促性腺激素≥300IU/d。比较不同促排卵方案的获卵数、正常受精数、可移植胚胎数等临床实验室数据。结果拮抗剂方案常规剂量组和高剂量组在获卵数、正常受精数、可移植胚胎数、获卵周期比率均分别高于微刺激方案组。按年龄分为>42岁组和≤42岁组,拮抗剂方案高剂量组与微刺激组比较,获卵数、正常受精数均分别高于微刺激组。拮抗剂方案常规剂量组与微刺激组比较,>42岁的患者获卵数、正常受精数均分别高于微刺激组,差异均有统计学意义。结论对于年龄≥40岁,且基础窦卵泡数≤5个的高龄低储备人群,首次促排卵方案建议选择拮抗剂常规刺激方案,可适量增加促性腺激素用量。Objectives To compared different doses of gonadotropin in order to explore the suitable ovulation promotion scheme for elderly infertile women with low ovarian reserve.Methods Retrospectively analyzed the outcomes of the first cycle ovulation induction regimens for 229 elderly patients(≥40 years old)with basal antral follicle count≤5 in the reproductive center of a tertiary hospital from January 1st,2014 to December 31st,2019.Mild stimulation regimen(66 cases,Gonadotropin≤150IU/d)and antagonist regimen(163 cases,Gonadotropin>150IU/d)were selected.The antagonist regimen group was divided into conventional dose group(88 cases,15042 and≤42 years old),the number of eggs and 2PN fertilization in the high dose group were higher than those in the mild stimulation group.Compared with the mild stimulation group,the number of eggs and 2PN fertilization in patients over 42 years old in the conventional dose group.All the difference was statistically significant.Conclusions For the population with advanced age and low reserve(age≥40 years,and basal antral follicle count≤5),it was recommended to choose the antagonist conventional stimulation protocol for the first ovulation induction scheme,and the dosage of Gonadotropin could be increased appropriately.

关 键 词：辅助生育技术 高龄 卵巢低储备 促性腺激素用量 获卵数 

分 类 号：R714.8[医药卫生—妇产科学]