拮抗剂与微刺激方案应用于高龄预期低预后患者临床结局分析  

Comparison of clinical outcomes between GnRH-ant and mild stimulation protocol in patients with advanced age and expected low prognosis

作　　者：张加盟 易建平[1] 韩宝生[1] 郭畅[1] 李宜学[1] ZHANG Jia-meng;YI Jian-ping;HAN Bao-sheng;GUO Chang;LI Yi-xue(Department of Reproductive Medicine,Tangshan Maternal&Children Hospital,Tangshan063100)

机构地区：[1]唐山市妇幼保健院,唐山063100

出　　处：《生殖医学杂志》2023年第2期214-219,共6页Journal of Reproductive Medicine

摘　　要：目的比较拮抗剂和微刺激方案应用于高龄预期低预后患者助孕结局的差异。方法回顾性分析2020年11月至2021年10月于唐山市妇幼保健院生殖医学中心行IVF/ICSI-ET的高龄预期低预后(波塞冬标准组4)患者的临床资料(共199个周期),根据促排卵方案不同分为拮抗剂组(88个周期)和微刺激组(111个周期)。比较两组患者的一般资料、促排卵情况、实验室指标、周期取消情况和妊娠结局。结果两组患者一般资料比较均无统计学差异(P>0.05)。拮抗剂组Gn用量、HCG日E2和P水平、获卵数、2PN数、可移植胚胎数、优质胚胎数均显著高于微刺激组(P<0.05),而HCG日LH水平显著低于微刺激组(P<0.05)。两组间周期取消率及取消原因比较均无统计学差异(P>0.05)。拮抗剂组鲜胚移植周期的胚胎种植率及临床妊娠率均显著高于微刺激组(P<0.05)。结论拮抗剂方案应用于高龄预期低预后患者有更好的临床结局,是一种理想的促排卵方案。Objective:To compare the pregnancy outcomes between GnRH antagonist(GnRH-ant)and mild stimulation protocol in the patients with advanced age and expected low prognosis.Methods:The clinical data of 199 cycles with advanced age and expected low prognosis patients(POSEIDON criterion group 4)who underwent IVF/ICSI-ET from November 2020 to October 2021 were retrospectively analyzed.According to different ovulation induction protocol,the patients were divided into two groups:88 cycles in GnRH-ant group and 111 cycles in mild stimulation group.The basic conditions,ovulation induction status,laboratory indexes,cycle cancellation status and pregnancy outcome were compared between the two groups.Results:There were no significant differences in the basic conditions between two groups(P>0.05).The Gn doses used,serum levels of progesterone and E2on HCG day,number of oocytes retrieved,number of 2PN embryos,number of transferable and high quality embryos in GnRH-ant group were significantly higher than those in mild stimulation group(P<0.05),while serum LH levels on HCG day was significantly lower than that in mild stimulation group(P<0.05).There were no significant differences in cycle cancellation rate and cancellation causes between the two groups(P>0.05).The embryo implantation rate and clinical pregnancy rate in GnRH-ant group were significantly higher than those in mild stimulation group(P<0.05).Conclusions:Application GnRH-ant protocol in the patients with advanced age and expected low prognosis can achieves better clinical outcomes,which is an ideal ovulation induction protocol.

关 键 词：拮抗剂方案 微刺激方案 波塞冬标准 高龄预期低预后 

分 类 号：R711.6[医药卫生—妇产科学]