卵巢储备正常不孕症患者改良长方案失败后改用拮抗剂方案助孕的自身对照研究  

Self-controlled study of switching to antagonist protocol after failure of modified long protocol in infertile patients with normal ovarian reserve

作　　者：彭伟 段超群 邓星 韩艳 张杰 PENG Wei;DUAN Chaoqun;DENG Xing;HAN Yan;ZHANG Jie(Department of Reproduction,Yichun Maternal and Child Health Hospital,Jiangxi Province,Yichun336000,China)

机构地区：[1]江西省宜春市妇幼保健院辅助生殖科,江西宜春336000

出　　处：《中国当代医药》2023年第19期76-80,共5页China Modern Medicine

基　　金：江西省宜春市科技计划项目(JXYC2021KSA036)。

摘　　要：目的分析卵巢储备正常的不孕症患者首次改良长方案失败后改用拮抗剂方案助孕的临床疗效。方法回顾性分析2017年7月至2022年3月在宜春市妇幼保健院治疗的卵巢储备正常且初次改良长方案促排卵助孕失败,再次治疗改用拮抗剂方案的54例不孕症患者的临床资料,采用前后自身对照的研究方法比较两种促排卵方案的临床结局。结果拮抗剂方案患者促性腺激素(Gn)总量、Gn天数低于改良长方案,人绒毛膜促性腺激素(HCG)日雌二醇、黄体生成素水平高于改良长方案,差异有统计学意义(P<0.05);两组的Gn启动量、HCG日孕酮、内膜厚度相比差异均无统计学意义(P>0.05)。拮抗剂方案患者获卵数、成熟卵率、总受精率、正常受精率、第3天优胚率、囊胚形成率均高于改良长方案,差异有统计学意义(P<0.05)。拮抗剂方案患者临床妊娠率为47.5%,高于改良长方案的12.8%,差异有统计学意义(P<0.05)。结论对于卵巢储备功能正常的不孕症患者,初次改良长方案失败后改用拮抗剂方案可降低Gn总量和Gn天数,提高获卵数,改善胚胎质量,提高临床妊娠率,获得更好的助孕结局。Objective To analyze the effect of antagonist protocol to assist pregnancy in infertile patients with normal ovarian reserve after the first pregnancy failure of modified long protocol.Methods The clinical data of 54 infertility patients with normal ovarian reserve who failed to promote ovulation by the first modified long regimen and were replaced by antagonist regimen were retrospectively analyzed in Yichun Maternal and Child Health Hospital from July 2017 to March 2022.The clinical outcomes of the two ovulation regimen were compared by self-control before and after treatment.Results The total amount of gonadotropin(Gn)and the number of days of Gn in antagonist program were lower than those in modified long program,while the levels of estradiol and luteinizing hormone in human chorionic gonadotropin(HCG)day were higher than those in modified long program,and the differences were statistically significant(P<0.05).There were no significant differences in Gn initiation amount,HCG daily hormone progesterone and intima thickness between the two groups(P>0.05).The number of eggs obtained,mature egg rate,total fertilization rate,normal fertilization rate,third day excellent embryo rate and blastocyst formation rate in patients with antagonist regimen were higher than those in patients with improved long regimen,and the differences were statistically significant(P<0.05).The clinical pregnancy rate of the antagonist program was 47.5%,which was higher than 12.8%of the modified long program,and the difference was statistically significant(P<0.05).Conclusion For patients with normal ovarian reserve who failed to pregnancy in modified long protocol for the first time,switching to the antagonist protocol can reduce the amount of Gn and the number of Gn days,increase the number of oocytes,improve the quality of embryos and clinical pregnancy rate,and achieve better pregnancy outcomes.

关 键 词：改良长方案 拮抗剂方案 卵巢储备正常 促排卵效果 临床妊娠率 

分 类 号：R711[医药卫生—妇产科学]