拮抗剂方案和温和刺激方案促排卵在高龄不孕症患者早期胚胎发育中的比较  

Comparison of early embryonic development in elderly infertility patients using antagonist and mild stimulation regimens for ovulation induction

作　　者：戴鹏涛 尹萍[1] 孙宁宇 贾林娜 李若华 梁天雪 严骅[1] DAI Pengtao;YIN Ping;SUN Ningyu;JIA Linna;LI Ruohua;LIANG Tianxue;YAN Hua(Reproductive Medicine Center,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院生殖医学中心,上海201203

出　　处：《中国医药科学》2025年第7期144-147,180,共5页China Medicine And Pharmacy

基　　金：国家自然科学基金资助项目(82104555)。

摘　　要：目的比较拮抗剂方案[促性腺激素释放激素拮抗剂促排卵]和温和刺激方案促排卵对高龄不孕女性的早期胚胎发育影响。方法回顾性分析2018年1月至2023年9月在上海中医药大学附属曙光医院生殖医学中心行体外受精的220例高龄女性(35~47岁)。按抗苗勒管激素(AMH)水平及促排卵方案,分为A组(n=76,AMH≤2 ng/ml,拮抗剂方案)、B组(n=56,AMH≤2 ng/ml,温和刺激方案)、C组(n=62,2 ng/ml<AMH≤6.8 ng/ml,拮抗剂方案)和D组(n=26,2 ng/ml<AMH≤6.8 ng/ml,温和刺激方案)。结果与B组比较,A组促性腺激素(Gn)使用天数、使用总量较高,获卵数、优质胚胎数、有效胚胎数较高,受精率、优质胚胎率、有效胚胎率较低,差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05)。与D组比较,C组Gn使用天数、使用总量较高,获卵数较高,优质胚胎率、有效胚胎率较低,差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05)。结论在高龄不孕症患者中,使用温和刺激方案较拮抗剂方案获得的优质胚胎率、有效胚胎率更高,Gn用量更少。Objective To compare the effects of the antagonist regimens(gonadotropin-releasing hormone antagonist ovulation induction)and mild stimulation regimens for ovulation induction on early embryonic development in elderly infertility women.Methods A total of 220 elderly women(35-47 years old)who underwent in vitro fertilization at the Reproductive Medicine Center,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2018 to September 2023 were analyzed retrospectively.According to the levels of anti-Müllerian hormone(AMH)and ovulation induction regimen,they were divided into Group A(n=76,AMH≤2 ng/ml,antagonist regimen),Group B(n=56,AMH≤2 ng/ml,mild stimulation regimen),Group C(n=62,2 ng/ml<AMH≤6.8 ng/ml,antagonist regimen)and Group D(n=26,2 ng/ml<AMH≤6.8 ng/ml,mild stimulation regimen).Results Compared with Group B,Group A had higher usage days and total amount of gonadotropin(Gn),higher number of retrieved eggs,high-quality embryos,and effective embryos,lower fertilization rate,high-quality embryo rate,and effective embryo rate,with statistically significant differences(P<0.05),and there were no statistically significant differences in other indices(P>0.05).Compared with Group D,Group C had higher usage days and total amount of Gn,higher number of retrieved eggs,lower rates of high-quality embryos and effective embryos,with statistically significant differences(P<0.05),and there were no statistically significant differences in other indices(P>0.05).Conclusion In elderly patients with infertility,the use of mild stimulation regimen yields higher rates of high-quality embryos and effective embryos compared to antagonist regimen,with less use of Gn.

关 键 词：不孕症 高龄 早期胚胎发育 拮抗剂方案 温和刺激方案 

分 类 号：R711.6[医药卫生—妇产科学]