常规促排卵方案治疗失败后的卵巢储备患者不同促排卵方案疗效分析  

Analysis on the efficacy of different ovulation induction protocols in patients with normal ovarian reserve after failure of conventional ovarian hyper-stimulation protocol

作　　者：刘丽 张燕 LIU Li;ZHANG Yan(Maternal and Child Health Hospital,Yinchuan 750001,China)

机构地区：[1]宁夏银川市妇幼保健院,宁夏银川750001

出　　处：《宁夏医学杂志》2024年第1期37-40,共4页Ningxia Medical Journal

基　　金：银川市科技局重点研发项目(2022ZDSF03)。

摘　　要：目的 探讨卵巢储备功能正常患者在第一周期采用激动剂长方案和拮抗剂方案治疗失败后,第二周期采用PPOS方案、拮抗剂方案和激动剂长方案治疗,评估不同方案治疗的效果。方法 回顾性分析后接受IVF/ICSI治疗的卵巢储备正常的不孕症患者资料,第一周期采用卵泡期长方案或拮抗剂方案促排卵、未获得妊娠者140例。2~3个月后行第二周期促排卵治疗,采用PPOS方案(A组)或者依然采用拮抗剂方案(B组)、卵泡期长方案(C组),行FET或ET,比较3组患者的基线资料及Gn总量、Gn天数、扳机日E2、获卵数、成熟卵率、正常受精率、可利用胚胎率、优质胚胎及妊娠结局。结果 3组患者的年龄、不孕年限、BMI、AMH、bFSH、bLH、bE2、Gn总量、扳机日E2、正常受精率、可利用胚胎率及优质胚胎比较差异均无统计学意义(P>0.05)。Gn天数比较,A组、B组Gn天数少于C组(P<0.05);获卵数中,A组获卵数多于C组(P<0.05);成熟卵率比较,A组低于C组(P<0.05)。结论 卵巢储备功能正常的患者,在第一周期采用常规方案失败后,第二周期采用PPOS方案、拮抗剂方案、长方案均可获得相当的临床妊娠率和累计妊娠率。由于PPOS方案周期时间短、用药简单、易于操作,对于常规方案失败的患者,根据患者的具体情况可选择PPOS作为其促排卵方案。Objective To investigate the efficacy of different regimens in patients with normal ovarian reserve who failed the first cycle of treatment with the long and antagonist regimens and treated with the PPOS regimen,antagonist regimen,and long regimen in the second cycle,and to assess the efficacy of the different regimens of treatment.Methods 140 infertile patients with normal ovarian reserve who underwent IVF/ICSI treatment and failed to achieve pregnancy in the first cycle of ovulation induction with follicular phase long regimen or antagonist regimen were retrospectively analyzed.The second cycle of ovulation induction treatment was performed 2~3 months later with PPOS regimen(group A)or still with antagonist regimen(group B)and follicular phase long regimen(group C).FET or ET was performed,the baseline data and total Gn,days to Gn,trigger day E 2,number of eggs obtained,mature egg rate,normal fertilization rate,available embryo rate,quality embryos and pregnancy outcome were compared in three groups.Results There was no significant difference in age,infertility years,BMI,AMH,bFSH,bLH,bE2,total amount of Gn,trigger day E 2,normal fertilization rate,available embryo rate and high-quality embryo among three groups(P>0.05).However,it was found that the number of Gn days in Group A and Group B was less than those in Group C(P<0.05).The number of eggs retrieved in group A was more than that in group C(P<0.05).The mature egg rate of group A was lower than that of group C(P<0.05).Conclusion For patients with normal ovarian reserve function,the routine regimen failed in the first cycle,PPOS regimen,antagonist regimen and agonist long regimen can be used in the second cycle to obtain a considerable clinical pregnancy rate and cumulative pregnancy rate.Due to the short cycle time,simple medication and easy operation,PPOS can be chosen as the ovulation induction program for patients who have failed the conventional regimen according to the patient′s specific situation.

关 键 词：卵巢储备功能正常 高孕激素状态下促排卵方案 激动剂长方案 拮抗剂方案 

分 类 号：R271.1[医药卫生—中医妇科学]