小剂量生长激素预处理在体外受精低质量胚胎患者中的应用  

Application of low-dose growth hormone pretreatment in patients with low quality embryos during in vitro fertilization

作　　者：郭奇 刘迎春 李玉[1] 宋小敏[1] 苏琳[1] 黄静[1] 汪静 倪丰[1] GUO Qi;LIU Ying-chun;LI Yu;SONG Xiao-min;SU Lin;HUANG Jing;WANG Jing;NI Feng(PLA Clinical College,Anhui Medical University,Hefei 230000)

机构地区：[1]安徽医科大学解放军临床学院,合肥230000

出　　处：《生殖医学杂志》2023年第6期818-822,共5页Journal of Reproductive Medicine

基　　金：安徽医科大学校基金资助项目(2021xkj242)。

摘　　要：目的探讨小剂量生长激素预处理对低质量胚胎患者妊娠结局的影响。方法回顾性分析2017年1月至2022年5月在中国人民解放军联勤保障部队第901医院生殖中心行两次体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕治疗的106例患者的临床资料,第一周期采用常规促排卵方案(拮抗剂或黄体期长方案),因无可移植胚胎或优质胚胎比例较低而助孕失败;第二周期使用小剂量重组人生长激素预处理后,再次采用相同促排卵方案,比较两个周期的胚胎发育情况和妊娠结局。结果重组人生长激素预处理后,第二周期HCG日E 2水平比第一周期有所增高,但无显著差异(P>0.05);第二周期获卵数及成熟卵母细胞数显著多于第一周期(P<0.05);第二周期的2PN受精率、可移植胚胎数、优质胚胎率、有可移植胚胎周期率、有优质胚胎周期率、累积妊娠率、胚胎种植率和早期流产率均显著高于第一周期(P<0.05);两个周期的Gn用量和天数、HCG日子宫内膜厚度以及HCG日的孕酮(P)水平均无显著差异(P>0.05);结论低剂量重组人生长激素预处理可以提高获卵数及胚胎质量,改善体外受精的临床结局。Objective:To explore the effect of low-dose recombinant human growth hormone(rGH)pretreatment on pregnancy outcome of patients with low quality embryo.Methods:The clinical data of 106 patients who underwent twice IVF/ICSI-ET in the reproductive center of the 901 st Hospital of the Joint Logistics Support Force of PLA,China from January 2017 to May 2022 were analyzed retrospectively.In the first cycle,conventional ovulation induction protocol(antagonist or long luteal phase protocol)was adopted,but the pregnancy failed due to the lack of transferable embryos or a low proportion of high-quality embryos.After pre-treatment with low-dose rGH in the second cycle,the same ovulation induction protocol was used again.The embryonic development and pregnancy outcomes were compared between the two cycles.Results:After rGH pretreatment,the E 2 level on HCG day of the second cycle increased compared to the first cycle,but there was no significant difference(P>0.05).The number of oocytes retrieved and mature oocytes in the second cycle were significantly higher than those in the first cycle(P<0.05).The 2PN fertilization rate,number of transferable embryos,high-quality embryo rate,transferable embryo cycle rate,high-quality embryo cycle rate,cumulative pregnancy rate,embryo implantation rate,and early abortion rate in the second cycle were significantly higher than those in the first cycle(P<0.05).There were no significant differences in Gn doses and days,endometrial thickness and progesterone levels on HCG day(P>0.05).Conclusions:Pretreatment with low-dose rGH can improve the number of oocytes retrieved and embryo quality and the clinical IVF outcome.

关 键 词：生长激素 体外受精-胚胎移植 胚胎质量 临床结局 

分 类 号：R715.2[医药卫生—妇产科学]