不同促排卵方案对行IVF/ICSI-ET助孕治疗的PCOS患者妊娠结局及胚胎实验室参数的影响  

Effects of different ovulation induction schemes on pregnancy outcome and embryo laboratory parameters in polycystic ovarian syndrome patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer assisted pregnancy therapy

作　　者：王书琴 孙海龙[1] 陈秀娟[1] WANG Shuqin;SUN Hailong;CHEN Xiujuan(Reproductive Medicine Center,the Affiliated Hospital of Inner Mongolia Medical University,Huhehaote 010000,China)

机构地区：[1]内蒙古医科大学附属医院生殖医学中心,呼和浩特010000

出　　处：《长春中医药大学学报》2024年第11期1260-1264,共5页Journal of Changchun University of Chinese Medicine

基　　金：内蒙古自治区自然科学基金项目计划(2023LHMS08054)。

摘　　要：目的分析不同促排卵方案对行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)助孕治疗的多囊卵巢综合征(PCOS)患者妊娠结局及胚胎实验室参数的影响。方法2018年6月-2019年9月内蒙古医科大学附属医院收治的行IVF/ICSI-ET助孕治疗PCOS患者134例,取得患者知情同意后,依据治疗方案的不同分为A组(早卵泡期长方案,47例,研究期间脱落2例,最终n=45,49个周期)、B组(长效长方案,32例,研究期间脱落1例,最终n=31,42个周期)以及C组(拮抗剂方案,55例,研究期间脱落3例,最终n=52,146个周期)。比较3组临床相关资料、妊娠结局、胚胎实验室参数及促排卵情况。结果与B组、C组比较,A组的新鲜胚胎移植率、临床妊娠率更高(P<0.05);与A组、B组比,C组的启动日促黄体生成素(LH)、雌二醇(E2)、HCG日LH水平均更高,促性腺激素(Gn)天数则更短,Gn剂量则更少(P<0.05)。结论IVF/ICSI-ET助孕治疗PCOS患者的三种促排卵方案中,早卵泡期长方案较其他方案,更能够提高患者的新鲜胚胎移植率、临床妊娠率;而拮抗剂方案较其他方案,则具有注射用醋酸曲普瑞林用药时间短、用药量少的特点,但在调节患者异常内分泌环境方面较差,因此临床应结合PCOS患者的实际情况,选择适合患者的促排卵方案。Objective To analyze the effects of different ovulation induction schemes on pregnancy outcome and embryo laboratory parameters in polycystic ovarian syndrome(PCOS)patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET).Methods From June 2018 to September 2019,134 PCOS patients who underwent IVF/ICSI-ET assisted pregnancy treatment were admitted to the Affiliated Hospital of Inner Mongolia Medical University.After obtaining informed consent from patients,they were divided into three groups based on different treatment schemes,namely Group A(long protocol for early follicular phase,47 cases,2 dropouts during the study period,and finally n=45,49 cycles),Group B(long protocol,32 cases,1 dropout during the study period,and finally n=31,42 cycles),and Group C(antagonist protocol,55 cases,3 dropouts during the study period,and finally n=52146 cycles).The clinical data,pregnancy outcome,embryo laboratory parameters and ovulation induction of three groups were compared.Results Compared with Group B and Group C,the fresh embryo transfer rate and clinical pregnancy rate in Group A were higher(P<0.05).Compared with the group A and the group B,the levels of luteinizing hormone(LH),estradiol(E2)and human chorionic gonadotropin(HCG)in the group C were higher on the start-up day,while the gonadotropin(Gn)days were shorter and Gn dose was lower(P<0.05).Conclusion Among the three ovulation induction schemes of IVF/ICSI-ET for PCOS patients,compare with other schemes,the long scheme during early follicular phase is more effective in improving the fresh embryo transfer rate and clinical pregnancy rate.Compared with other schemes,the antagonist scheme has the characteristics of shorter administration time and lower dosage of triptorelin acetate for injection,but it is less effective in regulating the abnormal endocrine environment of patients.Therefore,in clinical practice,the suitable ovulation induction scheme should be selected in combination with the actual situation of PCOS patie

关 键 词：多囊卵巢综合征 促排卵方案 体外受精/卵胞质内单精子注射-胚胎移植 妊娠结局 胚胎实验室参数 

分 类 号：R711.6[医药卫生—妇产科学]