拮抗剂方案中低LH水平患者不使用拮抗剂对助孕结果影响的研究  

Influence of GnRH antagonist on assisted pregnancy outcome in patients with low LH level in antagonist regimen

作　　者：刘明慧 李媛 韩烁 Liu Minghui;Li Yuan;Han Shuo(Center of Reproductive Medicine,Bejing Chao-Yang Hospital,Capital Medical University,Beijing 100020;Chengdu Xi'nan Gynecological Hospital,Chengdu Sichuan 610000,P.R.China)

机构地区：[1]首都医科大学附属北京朝阳医院生殖医学中心,北京100020 [2]成都西囡妇科医院生殖医学中心,四川成都610000

出　　处：《中国计划生育和妇产科》2023年第10期73-76,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨在拮抗剂方案中低LH水平患者不添加GnRH拮抗剂对体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)妊娠结局的影响。方法回顾性分析2020年6月至2021年8月于北京朝阳医院生殖医学中心行IVF-ET治疗的298例不孕症患者的临床资料,所有患者促排卵过程中LH最高值水平(LHmax)<4 IU/L,根据促排卵过程中是否添加GnRH拮抗剂,将患者分为无拮抗剂组(107例)和拮抗剂组(191例),比较两组患者的基本临床特征、促排卵过程中的临床和实验室指标、新鲜移植周期与全胚胎冷冻患者首个解冻移植周期妊娠结局。结果两组患者间年龄、不孕年限、体质量指数等基线特征差异均无统计学意义(P>0.05)。无拮抗剂组的临床妊娠率明显高于拮抗剂组(65.4%vs 53.4%,P<0.05)。在接受治疗的患者中,没有报告因过早排卵而取消周期的病例。结论在拮抗剂方案促排卵过程中,持续低LH水平(LHmax<4 IU/L)的患者不添加拮抗剂不会降低临床妊娠率。基于LH水平决定是否添加拮抗剂的新型治疗方案可能为临床医生提供拮抗剂给药的新见解。Objective To investigate the effect of GnRH antagonist on the pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET)in patients with low LH level.Methods 298 infertile patients who underwent IVF-ET in Beijing Chao-Yang Hospital Reproductive Medicine Center from June 2020 to August 2021 were retrospectively analyzed.According to the highest level of LH(LHmax)during ovulation induction,the patients with LHmax 4 IU/L were selected as the observation objects.According to whether GnRH antagonist was added during ovulation induction,the patients were divided into non-antagonist group(n=107)and antagonist group(n=191).The basic clinical characteristics,clinical and laboratory indexes in the process of ovulation induction,the pregnancy outcome of fresh transfer cycle and the first thawing transfer cycle were compared between the two groups.Results There was no significant difference in age,years of infertility and body mass index and other basic characteristics between the two groups(P>0.05).The clinical pregnancy rate in the non-antagonist group was significantly higher than that in the antagonist group(65.4%VS 53.4%,P<0.05).Among the treated patients,no cancellation of cycles happened due to premature ovulation.Conclusion In the process of ovulation induction with antagonist regimen,patients with low LH levels(LHmax 4 IU/L)during ovulation induction with antagonist regimens may not need antagonist.A new treatment protocol based on LH level to determine whether adding antagonist may provide clinicians with new insights into the administration of antagonist.

关 键 词：体外受精-胚胎移植 GNRH拮抗剂 黄体生成素 妊娠结局 

分 类 号：R715.5[医药卫生—妇产科学]