GnRH-a降调节联合雌孕激素替代疗法在多囊卵巢综合征冻融胚胎移植中的应用效果  

Application Effect of GnRH-a Downregulation Combined with Estrogen and Progesterone Replacement Therapy in Frozen-Thawed Embryo Transfer of Polycystic Ovarian Syndrome

作　　者：郭磊 Guo Lei(Reproductive Medicine Department,Xuzhou Maternity and Child Health Care Hospital,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州市妇幼保健院生殖医学科,江苏徐州221000

出　　处：《中国社区医师》2024年第29期24-26,共3页Chinese Community Doctors

摘　　要：目的:探讨促性腺激素释放激素激动剂(GnRH-a)降调节联合雌孕激素替代疗法在多囊卵巢综合征(PCOS)冻融胚胎移植(FET)中的应用效果。方法:选取2022年1—12月于徐州市妇幼保健院生殖医学科行FET的64例PCOS患者作为研究对象,随机分为联合组(n=32)与单用组(n=32)。单用组使用雌孕激素替代疗法治疗,联合组使用GnRH-a降调节联合雌孕激素替代疗法。比较两组患者的性激素水平、移植相关参数及临床结局。结果:治疗前,两组血清促黄体生成激素(LH)、促卵泡生成激素(FSH)、雌二醇(E_2)水平比较,无统计学差异(P>0.05);治疗后,两组LH、FSH、E_2水平显著下降,与单用组比较,联合组E_2、LH、FSH水平更低(P<0.05)。与单用组患者比较,联合组患者雌二醇片使用时间更短、使用剂量更少,胚胎植入时子宫内膜更厚(P<0.05);两组移植优质胚胎数比较,无统计学差异(P>0.05)。与单用组比较,联合组患者胚胎种植成功率更高(P<0.05);两组早期流产率、异位妊娠率比较,无统计学差异(P>0.05)。结论:GnRH-a降调节联合雌孕激素替代疗法在PCOS FET中的应用效果显著,可调控性激素水平,减少雌激素使用时间及剂量,增加患者子宫内膜厚度,提高胚胎种植成功率。Objective:To investigate the application effect of gonadotropin releasing hormone agonist(GnRH-a)downregulation combined with estrogen and progesterone replacement therapy in frozen-thawed embryo transfer(FET)of polycystic ovarian syndrome(PCOS).Methods:From January 2022 to December 2022,64 PCOS patients who underwent FET at the Reproductive Medicine Department of Xuzhou Maternity and Child Health Care Hospital were selected as the study subjects.They were randomly divided into a combination group(n=32)and a single use group(n=32).The single use group received estrogen and progesterone replacement therapy,while the combination group received GnRH-a downregulation combined with estrogen and progesterone replacement therapy.The sex hormone levels,transplant related parameters,and clinical outcomes of the two groups were compared.Results:Before treatment,there was no statistical difference in the levels of serum luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E2)between two groups(P>0.05);After treatment,the levels of LH,FSH and E2in two groups were significantly decreased;Compared with the single use group,the combination group had lower levels of E2,LH,and FSH(P<0.05).Compared with patients in the single use group,patients in the combination group had shorter usage time and less dosage of oestrogen,and had greater endometrial thickness at the time of embryo transfer(P<0.05).There was no statistical difference in the number of high-quality embryos transferred between the two groups(P>0.05).Compared with the single use group,the combination group had a higher success rate of embryo implantation(P<0.05).There was no statistical difference in the early abortion rate and ectopic pregnancy rate between the two groups(P>0.05).Conclusion:The application of GnRH-a downregulation combined with estrogen and progesterone replacement therapy in PCOS FET has significant effects,and can regulate the sex hormone levels,reduce estrogen usage time and dosage,increase endometrial thickness,and increase success

关 键 词：多囊卵巢综合征 冻融胚胎移植 促性腺激素释放激素激动剂降调节 雌孕激素替代疗法 

分 类 号：R711.6[医药卫生—妇产科学]