不同促排卵方案对多囊卵巢综合征患者体外受精-胚胎移植助孕结局的影响  

Effects of different ovulation stimulation protocols on IVF assisted pregnancy outcomes in patients with PCOS

作　　者：何雪梅 许晓璐 施迎迎 邓冰冰 林津[1] 张玲[1] 李萍[1] 

机构地区：[1]厦门大学附属妇女儿童医院(厦门市妇幼保健院)、厦门市生殖与遗传重点实验室、厦门市卫健委辅助生殖技术质控中心,福建厦门361000

出　　处：《中国妇幼保健》2024年第22期4447-4450,共4页Maternal and Child Health Care of China

基　　金：白求恩·医学科学研究基金项目(QL002DS);福建省厦门市医疗卫生指导性项目(3502Z20209195)。

摘　　要：目的 探讨多囊卵巢综合征(PCOS)患者采用不同促排卵方案对体外受精-胚胎移植(IVF-ET)助孕结局的影响。方法 回顾性分析2019年1月—2020年12月在厦门大学附属妇女儿童医院生殖医学中心行IVF-ET治疗的PCOS患者328个治疗周期,根据不同的促排卵方案分为两组:早卵泡期长方案组(A组)、拮抗剂方案组(B组)。比较两组患者的一般情况、卵巢刺激情况、实验室胚胎情况及助孕结局。结果 (1)两组患者年龄、不孕年限、基础卵泡刺激素(FSH)、基础黄体生成素(LH)/FSH、体质量指数(BMI)、抗苗勒氏管激素(AMH)、窦卵泡数(AFC)和获卵数、MII卵率、可移植胚胎率、平均移植胚胎数以及预防卵巢过度刺激综合征(OHSS)取消移植率、中重度OHSS发生率、流产率、异位妊娠率、累积分娩率、达到临床妊娠的时间(TPP)比较差异无统计学意义(P>0.05)。(2)A组患者的Gn总量[(1 842.39±594.610) IU]、Gn天数[(10.30±1.54)d]、扳机日内膜厚度[(11.27±2.19)mm]、卵子利用率[(55.10±20.16)%]和新鲜周期临床妊娠率(71.3%)明显B组[(1 485.08±476.43)IU、(8.78±1.17)d、(9.79±1.97)mm、(48.36±23.14)%、(51.9)%],差异均有统计学意义(均P<0.05);A组雌二醇(E_(2))水平、孕酮(P)水平明显低于B组,分别为[(4 030.20±2 336.67)vs.(5 084.12±3 167.53)pg/ml、(0.75±0.40)vs.(0.99±0.54)ng/ml]差异均有统计学意义(均P<0.05)。结论 早卵泡期长方案与拮抗剂方案的鲜胚移植率、达到临床妊娠的时间、中重度OHSS发生率和累积分娩率无明显差异,两种方案各有优势,均可为PCOS患者的促排卵方案。Objective To explore the impact of different ovulation stimulation protocols on the outcome of in vitro fertilization embryo transfer(IVF-ET)in patients with polycystic ovary syndrome(PCOS).Methods A retrospective analysis was conducted of 328 treatment cycles of PCOS patients undergoing IVF-ET treatment at the Reproductive Medicine Center of Women and Children's Hospital Affiliated to Xiamen University from January 2019 to December 2020.They were divided into two groups according to different ovulation stimulation proto-cols:early follicular phase rectangular protocol group(Group A)and GnRH-antagonist protocol group(Group B).The general situation,ovarian stimulation,laboratory embryo status,and assisted pregnancy outcomes of the two groups of patients were compared.Results①Age,infertility years,basal follicle stimulating hormone(FSH),basal luteinizing hormone(LH)/FSH,body mass index(BMI),anti Mullerian hormone(AMH),sinus follicle count(AFC)and oocyte acquisition,MII egg rate,transplantable embryo rate,av-erage number of transferred embryos,and prevention of OHSS cancellation rate,incidence of moderate to severe OHSS,abortion rate,ectop-ic pregnancy rate,cumulative delivery rate There was no significant difference in the time to clinical pregnancy(TPP)(P>0.05).②The total Gn count[(1842.39±594.610)IU],Gn days[(10.30±1.54)d],trigger day endometrial thickness[(11.27±2.19)mm],egg utilization rate[(55.10±20.16)%],and fresh cycle clinical pregnancy rate(71.3%)of patients in the follicular phase rectangular case group were significantly higher than those in the antagonist group[(1485.08±476.43)IU,(8.78±1.17)d,(9.79±1.97)mm,(48.36±23.14)%,and(51.9)%],with statistical differences;The levels of estradiol(E2)and progesterone(P)in the early follicular phase rectangular group were significantly lower than those in the antagonist group,which were(4030.20±2336.67)vs.(5084.12±3167.53)pg/ml,(0.75±0.40)vs.(0.99±0.54)ng/ml,respectively,with statistical differences(P<0.05).Conclusion There is no significant differenc

关 键 词：多囊卵巢综合征 促排卵方案 体外受精-胚胎移植 助孕结局 

分 类 号：R711[医药卫生—妇产科学]