不同促排卵方案应用于波塞冬4型POR患者的IVF临床结局比较  

Comparison of IVF outcomes of different ovulation induction regimens in patients with Poseidon Type 4 POR

作　　者：李蓉[1] 吴洋 曾玖芝[1] Li Rong;Wu Yang;Zeng Jiuzhi(Reproductive Center of Sichuan Maternal and Child Health Hospital,Chengdu Sichuan 610091,P.R.China)

机构地区：[1]四川省妇幼保健院生殖中心,四川成都610091

出　　处：《中国计划生育和妇产科》2023年第5期85-89,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨波塞冬4型患者体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)/单精子卵胞浆内注射(intracytoplasmic sperm injection,ICSI)技术助孕的3种促排卵方案(拮抗剂方案、高孕酮促排卵方案、微刺激方案)的临床效果。方法回顾性分析2018年1月至2021年6月在四川省妇幼保健院行IVF/ICSI-ET助孕的288例波塞冬4型患者的临床资料,将患者按不同促排卵方案分为3组:拮抗剂方案组122个周期、高孕酮方案组70个周期、微刺激方案组96个周期,比较各组患者促性腺激素(gonadotropin,Gn)总量、Gn天数、获卵数、成熟卵数、正常受精率、可利用胚胎数、周期取消率、临床妊娠率、早期流产率等。结果3组间的Gn总量差异均有统计学意义,拮抗剂方案组Gn总量最大、微刺激方案组Gn总量最小(P<0.05);拮抗剂方案组的Gn天数比高孕酮方案组及微刺激方案组长(P<0.05),高孕酮方案组和微刺激方案组比较差异无统计学意义(P>0.05);拮抗剂方案组的获卵数比高孕酮方案组及微刺激方案组高(P<0.05),高孕酮方案组和微刺激方案组之间比较差异无统计学意义(P>0.05);拮抗剂方案组的正常受精数、正常卵裂数、第3天可利用胚胎数、优质胚胎数均较高孕酮方案组及微刺激方案组高(P<0.05),高孕酮方案组和微刺激方案组之间比较差异无统计学意义(P>0.05);拮抗剂方案组可利用囊胚数较微刺激方案组多(P<0.05),3组的优质囊胚数差异无统计学意义(P>0.05);3组的周期取消率、着床率、临床妊娠率、早期流产率、异位妊娠率、多胎妊娠率、活产率差异均无统计学意义(P>0.05)。结论拮抗剂方案能获得最多的卵子、可利用胚胎、优质胚胎和可利用囊胚,可以新鲜周期移植、可获得更多的移植机会和累积妊娠率,故推荐该方案为波塞冬4型患者首次超促排卵的首选方案。Objective To investigate clinical effects of three ovulation induction regimens(antagonist regimen,high progesterone regimen,and micro-stimulation regimen)in in vitro fertilization-embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI)in patients with Poseidon Type 4.Methods The clinical data of 288 patients with Poseidon type 4 who received IVF/ICSI-ET assisted pregnancy in Sichuan Maternal and Child Health Hospital from January 2018 to June 2021 were retrospectively analyzed,and the patients were divided into three groups according to different ovulation induction schemes:122 cycles in the antagonist group,70 cycles in the high progesterone group and 96 cycles in the micro-stimulation group.Total gonadotropin(Gn),Gn days,number of eggs harvested,number of mature eggs,normal fertilization rate,number of available embryos,cycle cancellation rate,clinical pregnancy rate and early abortion rate were compared in each group.Results The difference of total Gn among the three groups was statistically significant,and the total Gn in the antagonist group was the largest,while the total Gn in the micro-stimulation group was the smallest(P<0.05).The Gn days in antagonist group were longer than those in high-progesterone group and micro-stimulation group(P<0.05),but there was no statistical significance between high-progesterone group and micro-stimulation group(P>0.05).The number of eggs obtained in antagonist group was higher than that in high-progesterone group and micro-stimulation group(P<0.05),but there was no statistical significance between high-progesterone group and micro-stimulation group(P>0.05).The number of normal fertilization,the number of normal cleavage,the number of available embryos at 3rd day and the number of high-quality embryos in antagonist group were higher than those in high-progesterone group and micro-stimulation group(P<0.05),but there was no statistical significance between high progesterone group and micro-stimulation group(P>0.05).The number of available blastocysts in the antagonist

关 键 词：卵巢低反应 拮抗剂方案 高孕酮促排卵方案 微刺激方案 

分 类 号：R713.7[医药卫生—妇产科学]