不同促排卵方案对行体外受精-胚胎移植助孕的卵巢低反应患者妊娠结局的影响  

Effect of different ovulation induction protocols on pregnancy outcomes of patients with poor ovarian response undergoing in vitro fertilization-embryo transfer

作　　者：陈英[1] 殷晨星[1] 王玉真[1] 陈晨 赵甜甜 师楠 CHEN Ying;YIN Chenxing;WANG Yuzhen;CHEN Chen;ZHAO Tiantian;SHI Nan(Department of Reproductive Medicine,Baoding Maternal and Child Health Hospital,Baoding 071000,Hebei,China)

机构地区：[1]保定市妇幼保健院生殖医学科,河北保定071000

出　　处：《中国性科学》2024年第10期60-64,共5页Chinese Journal of Human Sexuality

基　　金：保定市科技计划项目(2141ZF285)。

摘　　要：目的探讨卵巢低反应(POR)患者在体外受精-胚胎移植(IVF-ET)助孕中采用不同促排卵方案的妊娠结局。方法回顾性分析2018年5月至2022年5月在保定市妇幼保健院接受体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)助孕的214例POR患者的临床资料,根据不同促排卵方案分为A组(n=76)、B组(n=73)、C组(n=65)。A组采用短方案,B组采用拮抗剂方案,C组采用微刺激方案。比较三组扳机日激素水平、子宫内膜厚度、促性腺激素(Gn)使用天数及用量、治疗情况、妊娠结局。结果扳机日,C组黄体生成素(LH)高于A组、B组,子宫内膜厚度低于A组、B组,A组雌二醇(E2)高于B组、C组(P<0.05);A组和B组LH、子宫内膜厚度比较,B组和C组E2比较,差异无统计学意义(P>0.05)。Gn使用天数和用量均为A组>B组>C组(P<0.05)。C组平均获卵数、平均可用胚胎数、平均优质胚胎数均少于A组、B组(P<0.05);A组和B组平均获卵数、平均可用胚胎数、平均优质胚胎数比较,差异无统计学意义(P>0.05)。B组临床妊娠率高于A组、C组(P<0.05);A组和C组妊娠率比较,差异无统计学意义(P>0.05)。结论POR患者接受IVF-ET助孕过程中采用不同促排卵方案会影响妊娠结局,拮抗剂方案较短方案和微刺激方案更具有优势。Objective To explore the pregnancy outcomes of different ovulation induction protocols in patients with poor ovarian response(POR)undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods The clinical data of 214 patients with POR who received in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)in Baoding Maternal and Child Health Hospital from May 2018 to May 2022 were retrospectively analyzed.According to the different ovulation induction protocols,they were divided into group A(n=76),group B(n=73)and group C(n=65).Group A adopted short protocol,group B adopted antagonist protocol,and group C adopted micro-stimulation protocol.The hormones levels and endometrial thickness on the trigger day,the number of days and dosage of gonadotropin(Gn),treatment status and pregnancy outcomes were compared among the three groups.Results On the trigger day,the luteinizing hormone(LH)in group C was higher than that in group A and group B,and the endometrial thickness was thinner than that in group A and group B.The estradiol(E2)in group A was higher than that in group B and group C(P<0.05),but there were no statistical differences in the LH and endometrial thickness between group A and group B and the E2 between group B and group C(P>0.05).The number of days and dosage of Gn were manifested as group A>group B>group C(P<0.05).The average number of oocytes retrieved,the average number of available embryos and the average number of high-quality embryos were less in group C than those in group A and group B(P<0.05),but no statistical differences were shown between group A and group B(P>0.05).The clinical pregnancy rate in group B was higher compared to those in group A and group C(P<0.05),but there was no statistical significance between group A and group C(P>0.05).Conclusions The use of different ovulation induction protocols during IVF-ET assisted pregnancy in patients with POR will affect the pregnancy outcomes,and antagonist protocol has more advantages than the short protocol and micros

关 键 词：卵巢低反应 体外受精-胚胎移植 促排卵方案 妊娠结局 

分 类 号：R711[医药卫生—妇产科学]