不同剂量生长激素对控制性超促排卵中高龄患者妊娠结局的影响  

Effects of different dosages of growth hormone on pregnancy outcome in elderly patients with controlled ovulation induction

作　　者：赵帅[1] 邱月 张建伟[1] ZHAO Shuai;QIU Yue;ZHANG Jian-wei(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Ji'nan,Shandong 250011,China;不详)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250011 [2]山东中医药大学附属医院

出　　处：《中国妇幼保健》2024年第13期2435-2438,共4页Maternal and Child Health Care of China

基　　金：国家自然科学基金资助项目(82104914);山东省自然科学基金青年项目(ZR2020QH313)。

摘　　要：目的 探讨体外受精-胚胎移植(IVF-ET)过程中控制性超促排卵(COH)的高龄患者补充生长激素(GH)的最小有效剂量。方法 选取2020年2月—2021年6月在山东中医药大学附属医院妇产生殖中心采用拮抗剂方案行IVF-ET或卵胞浆内单精子注射(ICSI)治疗的患者67例,均给予促性腺激素(Gn)。研究组34例,自COH第1天加用GH,4 IU/d,至人绒毛膜促性腺激素(hCG)日;对照组33例,自COH第1天加用GH,2 IU/d,至hCG日。比较两组患者的hCG日雌激素水平、COH天数、Gn用量、获卵数、2PN受精率、优质胚胎率以及临床妊娠率。结果 研究组COH天数、Gn用量、hCG日雌二醇(E_(2))水平、获卵数、2PN受精率、优质胚胎率、临床妊娠率分别为(8.52±0.96)d、(1 828.71±342.38)IU、(923.18±528.50)pg/ml、(3.15±0.59)个、63.64%、42.86%、26.47%;对照组COH天数、Gn用量、hCG日E_(2)水平、获卵数、2PN受精率、优质胚胎率、临床妊娠率分别为(8.99±0.97)d、(1 925.17±436.21)IU、(885.00±409.13)pg/ml、(3.13±0.52)个、62.50%、40.00%、24.24%。两组的COH天数、Gn用量、hCG日E_(2)水平、获卵数、2PN受精率、优质胚胎率及临床妊娠率比较,研究组均优于对照组,但是两组比较差异均无统计学意义(t=-0.561,-0.653,-0.471,0.583,0.033,0.128,0.044,均P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 GH的添加对于高龄不孕患者有切实有效的治疗作用。对COH过程中的高龄不孕患者,补充小剂量GH即可减少COH天数及Gn用量,改善卵巢的反应性,提高hCG日E_(2)水平,增加获卵数及受精率,改善妊娠结局。Objective To explore the minimum effective dose of growth hormone(GH)supplementation in elderly patients during controlled ovarian hyperstimulation(COH)of in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 67 patients undergoing IVF-ET or intracytoplasmic sperm injection(ICSI)with antagonist were given gonadotropin(Gn)in Maternity and Reproductive Center of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from February 2020 to June 2021.In study group,34 patients were added with GH,4 IU/d,until human chorionic gonadotropin(hCG)day from the first day of COH.In control group,33 patients were added with GH,2 IU/d until hCG day from the first day of COH.The levels of estrogen on hCG day,COH days,Gn dose,number of retrieved oocytes,2 diprokaryote nuclears(2PN)fertilization rates,high-quality embryo rates,and clinical pregnancy rates in the two groups were compared.Results In study group,COH days,Gn dose,estradiol(E_(2))level on hCG day,number of retrieved oocytes,2PN fertilization rate,high-quality embryo rate,and clinical pregnancy rate were(8.52±0.96)days,(1828.71±342.38)IU,(923.18±528.50)pg/ml,(3.15±0.59),63.64%,42.86%,and 26.47%,respectively.In control group,COH days,Gn dose,estradiol(E_(2))level on hCG day,number of retrieved oocytes,2PN fertilization rate,high-quality embryo rate,and clinical pregnancy rate were(8.99±0.97)days,(1925.17±436.21)IU,(885.00±409.13)pg/ml,(3.13±0.52),62.50%,40.00%,and 24.24%,respectively.The above-mentioned indexes in study group were superior to control group,but there was no statistically significant difference(t=-0.561,-0.653,-0.471,0.583,0.033,0.128,0.044,all P>0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion For the elderly patients during COH,supplementing small dose of GH can reduce COH days and the dosage of Gn,improve ovarian reactivity,increase the level of E_(2) on hCG day,increase the number of retrieved oocytes and the rate of fertilization,and im

关 键 词：控制性超促排卵 高龄 生长激素 妊娠结局 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学]