3种促排卵方案在卵巢储备功能减退患者中的应用  

Application of Three Ovulation Induction Protocols on Patients with Diminished Ovarian Reserve

作　　者：朱佳颖[1] 王栋娜 杨璐 管瑞君 王艳 郭珍[1] 杨红梅 甄敬辉 陈丹朔 王蔼明 ZHU Jiaying;WANG Dongna;YANG Lu;GUAN Ruijun;WANG Yan;GUO Zhen;YANG Hongmei;ZHEN Jinghui;CHEN Danshuo;WANG Aiming(Department of Reproductive Medicine,Zhuozou City Hospital)

机构地区：[1]涿州市医院生殖医学科,河北涿州072750 [2]中国人民解放军第六医学中心妇产科生殖中心

出　　处：《长治医学院学报》2023年第4期261-264,共4页Journal of Changzhi Medical College

基　　金：保定市科技计划项目(1941ZF099);吴阶平医学基金会资助项目(320.6750.2021-19-3)。

摘　　要：目的:探讨3种促排卵方案对卵巢储备功能减退(DOR)患者胚胎发育的影响。方法:回顾性分析行体外受精-胚胎移植助孕治疗的DOR患者共140个周期的临床资料,按照促排卵方案不同分为3组,微刺激方案组40个周期、拮抗剂方案组40个周期、高孕激素下促排卵(PPOS)方案组60个周期。比较各组患者的一般资料、激素水平、促排卵及胚胎发育情况。结果:3组患者治疗后人绒毛膜促性腺激素(HCG)注射日激素水平比较,微刺激组E 2[(883.33±134.84)ng·L^(-1)]低于拮抗剂组[(993.53±110.24)ng·L^(-1)]和PPOS组[(1325.39±128.97)ng·L^(-1)](P<0.05);3组间促黄体素(LH)、孕激素(P)、临床妊娠率和活产率差异无统计学意义(P>0.05);PPOS组促排后其获卵数(5.67±1.16)、成熟(MⅡ)卵数(4.77±1.52)、正常受精数(3.27±0.86)、优胚数(2.73±0.69)和可利用胚胎数(3.00±0.88)均高于其他2组(P<0.05);拮抗剂组的MⅡ数(3.03±1.07)、正常受精数(2.25±0.78)、优胚数(1.48±0.55)、可利用胚胎数(1.73±0.60)分别高于微刺激组的[(1.58±0.59)、(1.20±0.61)、(0.75±0.44)、(0.90±0.38),P<0.05];外源性促性腺激素(Gn)用药量PPOS组[(2018.27±346.17)IU)]和拮抗剂组[(2029.17±339.44)IU]均高于微刺激组[(1680.86±309.22)IU](P<0.05)。结论:对于DOR患者,3种方案中PPOS方案胚胎结局最好,其次是拮抗剂方案。Objective:To explore the effects of three ovulation induction protocols on the embryonic development of patients with diminished ovarian reserve(DOR).Methods:Retrospective analysis was conducted on the clinical data of 140 cycles of DOR patients undergoing IVF-ET assisted pregnancy treatment.They were divided into three groups according to different ovulation promotion schemes,including 40 cycles in the mini-stimulation scheme group,40 cycles in the antagonist scheme group,and 60 cycles in the PPOS scheme group.The general information,ovulation promotion,and embryo development of patients in each group were compared.Results:Comparison of hormone levels on the day of injection of human chorionic gonadotropin(HCG)in three groups of patients after treatment:the mini-stimulation group was lower than the antagonist group and the PPOS group(P<0.05);there were no statistically significant differences in luteinizing hormone(LH),progesterone(P),clinical pregnancy rate,and live birth rate among the three groups(P>0.05);After ovulation induction,the number of retrieved oocytes,mature(MⅡ)oocytes,normal fertilization,excellent embryos,and available embryos in the PPOS group were higher than those in the other two groups(P<0.05);the number of MⅡoocytes,normal fertilization,excellent embryos,and available embryos in the antagonist group were significantly higher than those in the mini-stimulation group(P<0.05);the dosage of exogenous gonadotropin(Gn)in the PPOS group and the antagonist group was higher than that in the mini-stimulation group(P<0.05).Conclusions:For patients with diminished ovarian reserve(DOR),the PPOS regimen had the best embryonic outcome among the three regimens,followed by the antagonist regimen.

关 键 词：卵巢储备功能减退 PPOS方案 拮抗剂方案 微刺激方案 

分 类 号：R714.8[医药卫生—妇产科学]