拮抗剂方案黄体支持中添加GnRHa对体外受精-胚胎移植妊娠结局的影响  

Effect of adding GnRHa to luteal support in antagonist protocols on pregnancy outcomes in IVF-ET

作　　者：覃金春 张译升 池艳 黄泰帅 夏小灵 覃捷 QIN Jin-chun;ZHANG Yi-sheng;CHI Yan;HUANG Tai-shuai;XIA Xiao-ling;QIN Jie(Reproductive Medicine and Genetics Center of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区：[1]广西壮族自治区生殖医学与遗传中心,广西南宁530021

出　　处：《广东医学》2024年第8期976-980,共5页Guangdong Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹课题(Z20201059);广西壮族自治区自然科学基金(2022JJA40404)。

摘　　要：目的阐明醋酸曲谱瑞林(GnRHa)在体外受精-胚胎移植(IVF-ET)拮抗剂方案黄体支持中的作用。方法采用1∶1倾向评分匹配,回顾性分析2021年11月至2022年12月在广西壮族自治区生殖医学与遗传中心就诊,符合纳入标准的146例患者病历资料。根据黄体支持不同分2组。对照组73例:常规黄体支持;GnRHa组73例:常规黄体支持+GnRHa。比较两组的基线资料及妊娠结局。结果两组基线资料差异无统计学意义(P>0.05)。GnRHa组优质胚胎的占比明显低于对照组(73.43%vs.83.33%,P=0.041),但与对照组相比,GnRHa组种植率、临床妊娠率、多胎率、早期流产率、继续妊娠率、活产率均升高,而生化妊娠率、早期流产率均降低,虽然差异均无统计学意义(P>0.05)。结论拮抗剂方案添加GnRHa黄体支持可能有益,但在广泛应用于临床之前,需多中心、大样本的RCT进行论证,以明确不同人群添加GnRHa黄体支持的利弊。Objective To elucidate the role of triptorelin acetate(GnRHa)in luteal support during antagonist protocols for in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was conducted using 1:1 propensity score matching on 146 patient records from November 2021 to December 2022 at our center.Patients were divided into two groups based on their luteal support regimen.The control group(n=73)received standard luteal support,while the GnRHa group(n=73)received standard luteal support plus GnRHa.Baseline characteristics and pregnancy outcomes were compared between the groups(P>0.05).Results There were no significant differences in baseline characteristics between the groups.The proportion of high-quality embryos was significantly lower in the GnRHa group compared to the control group(73.43%us.83.33%,P=0.041).However,compared to the control group,the GnRHa group showed increased implantation rates,clinical pregnancy rates,multiple pregnancy rates,ongoing pregnancy rates,and live birth rates,while the biochemical pregnancy rates and early miscarriage rates were decreased.These differences were not statistically significant(P>0.05).Conclusion Adding GnRHa to luteal support in antagonist protocols may be beneficial.However,large-scale multicenter randomized controlled trials(RCTs)are required to further clarify the advantages and disadvantages of this approach across different patient populations before widespread clinical application.

关 键 词：拮抗剂方案 醋酸曲谱瑞林 黄体支持 体外受精-胚胎移植 

分 类 号：R246.3[医药卫生—针灸推拿学] R271.14[医药卫生—中医临床基础]