改良长效长方案与拮抗剂方案对卵巢储备功能减退患者子宫内膜容受性的影响对比  

A comparison of the effects of modified long-acting regimen and antagonist regimen on endometrial receptivity in patients with ovarian reserve dysfunction

作　　者：房丽娜 王德佳[1] 李妍仪 董超 许丽丽 史兆松 李越东 Fang Lina;Wang Dejia;Li Yanyi;Dong Chao;Xu Lili;Shi Zhaosong;Li Yuedong(Department of Reproductive Medicine,Chengde Central Hospital,Chengde Hebei 067000,P.R.China)

机构地区：[1]承德市中心医院生殖医学科,河北承德067000

出　　处：《中国计划生育和妇产科》2024年第6期49-52,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：2022年承德市科技计划自筹经费项目(第三批)(项目编号:202204A006)。

摘　　要：目的 探讨卵巢储备功能减退行体外受精-胚胎移植(in vitro fertilization-embryo transfer, IVF-ET)助孕患者使用改良长效长方案与拮抗剂方案对子宫内膜容受性的影响。方法 选取2018年7月至2023年1月承德市中心医院120例接受IVF-ET助孕的卵巢储备功能减退患者。采用随机数字表法分为拮抗剂组和改良长效长方案组,各60例。拮抗剂组采用促性腺激素释放激素(gonadotropin releasing hormone, GnRH)拮抗剂方案,改良长效长方案组采用GnRH激动剂改良长效长方案。比较两组促性腺激素(gonadotropin, Gn)使用量、Gn使用天数,hCG注射日促黄体生成素(luteotropic hormone, LH)、雌二醇、孕酮水平、子宫内膜厚度,记录两组鲜胚移植数、着床率、鲜胚移植临床妊娠率。结果 与拮抗剂组比较,改良长效长方案组Gn使用量较高、使用天数较长(P<0.05)。改良长效长方案组hCG注射日的LH水平低于拮抗剂组,雌二醇、子宫内膜厚度高于拮抗剂组,鲜胚移植数多于拮抗剂组,差异均有统计学意义(P<0.05)。改良长效长方案组着床率、临床妊娠率高于拮抗剂组,差异无统计学意义(P>0.05)。结论 卵巢储备功能减退行IVF-ET助孕患者使用GnRH拮抗剂方案和GnRH激动剂改良长效长方案效果相当,GnRH拮抗剂方案可减少Gn使用时间、用量,GnRH激动剂改良长效长方案在改善患者子宫内膜方面更具优势,临床可根据实际情况选择方案。Objective To investigate the effects of modified long-acting regimen and antagonist regimen on endometrial receptivity in patients with ovarian reserve dysfunction undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 120 patients with reduced ovarian reserve function who received IVF-ET assisted pregnancy in Chengde Central Hospital from July 2018 to January 2023 were selected.Random number table method was used to divide the patients into modified long-acting long program group and antagonist group,60 cases in each group.In the antagonist group,gonadotropin-releasing hormone(GnRH)antagonist scheme was used,and in the modified long-acting long program group,GnRH agonist was used to improve long-acting long acting scheme.The dosage of gonadotropin(Gn),the days of Gn use,the levels of luteotropic hormone(LH),estradiol,progesterone and endometrial thickness on the day of hCG injection were compared between the two groups.The number of fresh embryo transplantation,implantation rate and clinical pregnancy rate of fresh embryo transplantation were recorded in the two groups.Results Compared with the antagonist group,the dosage of Gn was higher and the use days of Gn were longer in the modified long-acting long program group(P<0.05).The LH level of the modified long-acting long program group on hCG injection day was lower than that of the antagonist group,and the estradiol,endometrial thickness and the number of fresh embryos transplanted were higher than those of the antagonist group,the differences were statistically significant(P<0.05).The implantation rate and clinical pregnancy rate in the modified long-acting long program group were higher than those in the antagonist group,and there was no significant difference(P>0.05).Conclusions GnRH antagonist scheme and GnRH agonist modified long-acting scheme have the same effect in IVF-ET assisted pregnancy patients with ovarian reserve dysfunction,GnRH antagonist scheme can reduce the use time and dosage of Gn,and GnRH agonist modified long-acting

关 键 词：卵巢储备功能减退 体外受精-胚胎移植 促性腺激素释放激素 子宫内膜容受性 

分 类 号：R711.75[医药卫生—妇产科学]