黄体支持中添加短效GnRHa对IVF-ET妊娠结局的影响  

Administration Effects of Short-Acting GnRH Agonist for Luteal Phase Support in IVF-ET Cycles

作　　者：宋梦玲[1] 陈琰[1] 王飞苗[1] 李永丽[1] 胡蓉[1] SONG Mengling;CHEN Yan;WANG Feimiao;LI Yongli;HU Rong(Reproductive Medicine Center,General Hospital of Ningxia Medical University,First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院生殖医学中心,宁夏医科大学第一临床医学院,银川750004

出　　处：《宁夏医科大学学报》2023年第12期1222-1227,1249,共7页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金重点项目(2021AAC02026);宁夏回族自治区科技惠民项目(2023CMG03023)。

摘　　要：目的应用实时荧光定量RT-PCR技术检测月经不同时期子宫内膜中促性腺激素释放激素(GnRH)mRNA及促性腺激素释放激素受体(GnRHR)mRNA的表达量,同时在黄体期添加单剂量短效GnRHa,研究其对妊娠结局的影响。方法收集2018年7月1日至2020年6月30日于宁夏医科大学总医院生殖中心应用拮抗剂方案首次进行体外受精-胚胎移植(IVF-ET)助孕的60例不孕患者增殖期和种植窗期的子宫内膜,采用RT-PCR技术分别检测GnRH mRNA及GnRHR mRNA的表达量,比较两个时期两种基因的表达水平。60例患者移植后3 d在常规黄体支持基础上添加短效GnRHa 0.1 mg,作为研究组;同期应用拮抗剂方案的60例体外受精(IVF)患者采用常规黄体支持,作为对照组,比较两组患者的胚胎着床率、临床妊娠率、多胎妊娠率、持续妊娠率、卵巢过度刺激综合征(OHSS)发生率及早期流产率。结果种植窗期子宫内膜中的GnRH mRNA及GnRHR mRNA的表达量均高于增殖期(P均<0.05);研究组的胚胎着床率、临床妊娠率、多胎妊娠率、持续妊娠率及活产率均高于对照组(P均<0.05),而两组间OHSS发生率、早期流产率及异位妊娠率的比较,差异均无统计学意义(P均>0.05)。结论黄体支持中添加单剂量短效GnRHa可改善应用拮抗剂方案的IVF-ET助孕患者的妊娠结局。Objective To detect the expression of GnRH mRNA and GnRHR mRNA in endometrium of different periods of menstruation by real-time quantitative RT-PCR,and to explore the relationship between GnRH and pregnancy outcome by adding a single dose of short-acting GnRHa in luteal phase.Methods The endometrium during the proliferation and implantation window of 60 infertile patients who were assisted by IVF-ET for the first time from 1 July 2018 to 30 June 2020 were collected.The expression of GnRH mRNA and GnRHR mRNA were detected by real-time quantitative RT-PCR,and the difference between the two genes was compared.Sixty patients were added 0.1 mg of short-acting GnRHa on the basis of routine luteal support three days after transplantation as the study group.At the same time,60 IVF patients who received the antagonist regimen at the same time received routine luteal support as the control group.Embryo implantation rate,clinical pregnancy rate,multiple pregnancy rate,ongoing pregnancy rate,OHSS rate and early abortion rate were compared between the two groups.Results The expression of GnRH mRNA and GnRHR mRNA in endometrium during implantation window was significantly higher than that in proliferation stage(P all<0.05).The implantation rate,clinical pregnancy rate,multiple pregnancy rate,ongoing pregnancy rate and live birth rate of the study group were higher than those of the control group(P all<0.05).There was no significant difference in the incidence of OHSS,early abortion rate and ectopic pregnancy rate between the two groups(P all>0.05).Conclusion Adding a single dose of short-acting GnRHa to corpus luteal support may benefit IVF patients with antagonist regimen.

关 键 词：促性腺激素释放激素 促性腺激素释放激素受体 促性腺激素释放激素激动剂 体外受精-胚胎移植 黄体支持 

分 类 号：R714.8[医药卫生—妇产科学]