拮抗剂促排卵方案反向黄体生成素添加对高龄卵巢储备减退患者体外受精-胚胎移植妊娠结局的影响  

Effect of Antagonist Ovulation Promotion Regimen Reverse Luteinizing Hormone Addition on Pregnancy Outcome of In Vitro Fertilization embryo Transfer in Elderly Patients with Decreased Ovarian Reserve

作　　者：陈瑜[1] 程婷婷[1] CHEN Yu;CHENG Tingting(Department of Reproductive Medicine,Xuzhou Maternal and Child Health Hospital,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州市妇幼保健院生殖医学科,江苏徐州221000

出　　处：《中外医疗》2023年第34期31-34,38,共5页China & Foreign Medical Treatment

摘　　要：目的 探讨分析高龄卵巢储备减退(decreased ovarian reserve, DOR)患者体外受精-胚胎移植(in vitro fertilization-embryo transfer, IVF-ET)中采用拮抗剂促排卵方案反向黄体生成素添加对妊娠结局的影响。方法选取2020年3月—2023年1月于徐州市妇幼保健院生殖医学科就诊的首次行IVF-ET助孕的高龄DOR患者80例临床资料开展回顾性研究,根据是否添加黄体生成素将其分为对照组和研究组,其中接受单独卵泡刺激素治疗的40例患者纳入对照组;于促性腺激素释放激素拮抗日开始添加黄体生成素至扳机日的40例患者纳入观察组。比较两组治疗前后促排卵情况,2PN受精率、优质胚胎率,同时统计两组着床率、妊娠率。结果 观察组可利用胚胎数高于对照组,差异有统计学意义(P<0.05);观察组2PN受精率、优质胚胎率分别为82.50%、55.00%,均高于对照组的62.50%、32.50%,差异有统计学意义(χ^(2)=4.013、4.114,P<0.05);观察组着床率、妊娠率分别为35.00%、45.00%,均高于对照组的15.00%、22.50%,差异有统计学意义(P<0.05)。结论 高龄DOR患者首次行IVF-ET使用拮抗剂促排卵方案中适时增加黄体生成素干预,可在一定程度上可改善其卵子质量,保障着床率、妊娠率。Objective To investigate and analyze the effect of antagonist ovulation promotion regimen reversing lutein-izing hormone addition on pregnancy outcome in In vitro fertilization-embryo transfer(IVF-ET)in elderly patients with diminished ovarian reserve(DOR),and to determine the effect of antagonist ovulation promotion regimen on preg-nancy outcome.Methods A retrospective study was conducted on 80 cases of elderly DOR patients clinical data who underwent IVF-ET for the first time in the Department of Reproductive Medicine of Xuzhou Maternal and Child Health Hospital from March 2020 to January 2023.They were categorized into control group and observation group based on the addition of luteinizing hormone or not,of which 40 patients who received follicle stimulating hormone alone were included in the control group.The 40 patients who started adding luteinizing hormone on the day of gonadotropin-releasing hormone antagonism to the day of trigger were included in the observation group.The two groups were compared before and after treatment for ovulation promotion,2PN fertilization rate,high-quality embryo rate,as well as statistics of the two groups'implantation rate and pregnancy rate.Results The number of available em-bryos in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The fertilization rate of 2PN and the rate of high-quality embryos in the observation group were 82.50%and 55.00%,respectively,which were higher than those of 62.50%and 32.50%in the control group,and the differences were statistically significant(χ^(2)=4.013,4.114,P<0.05).The observation group had a 35.00%and 45.00%implantation rate and pregnancy rate,respectively,which were higher than the 15.00%and 22.50%of the control group,and the differences were statistically significant(P<0.05).Conclusion The timely addition of luteinizing hormone in the first IVF-ET regimen of antagonist ovulation promotion in elderly patients with DOR can improve the quality of their eggs to a certa

关 键 词：高龄卵巢储备减退 拮抗剂促排卵方案 黄体生成素 体外受精-胚胎移植 着床率与妊娠率 

分 类 号：R711[医药卫生—妇产科学]