卵巢高反应患者人绒毛膜促性腺激素扳机剂量的探讨

发布时间：2018-02-20 07:27

本文关键词： 人绒毛膜促性腺激素受精体外胚胎移植卵巢过度刺激综合征　出处：《中国现代医学杂志》2015年27期 　论文类型：期刊论文

【摘要】：目的探讨体外受精-胚胎移植(IVF-ET)周期中,何种人绒毛膜促性腺激素(h CG)扳机剂量为卵巢高反应患者的合适选择。方法选择2013年1月-2014年5月在湘潭市中心医院生殖遗传中心行IVF-ET的卵巢高反应患者465例,根据扳机日h CG的注射剂量分h CG 2 000 IU组(A组)、3 000 IU组(B组)、4 000IU组(C组)、5 000 IU组(D组)。比较各组间的中、重度卵巢过度刺激综合征(OHSS)发生情况、获卵率、卵子成熟率、受精率、2PN受精率、可利用胚胎率、优胚率及新鲜周期移植后妊娠结局。结果 A组获卵率明显低于其他各组,D组获卵率明显高于其他各组,差异有统计学意义(78.5%vs 87.2%,87.8%vs 92.3%)。A组和B组卵子成熟率及2PN受精率较C组和D组低,差异有统计学意义。A组受精率明显低于其他各组,差异有统计学意义(84.3%vs 88.3%,90.6%,90.2%)。C组可利用胚胎率显著高于A组和B组,也显著低于D组(67.9%,66.2%vs 76.2%vs 80.3%)。D组优胚率显著高于其他各组(46.0%,45.1%,49.5%vs 59.2%)。A组、B组、C组的中、重度早发型OHSS发生率无差异,均显著低于D组(0.9%,1.9%,1.8%vs 5.9%)。4组均无中、重度晚发型OHSS发生。各组间新鲜周期生化妊娠率、临床妊娠率无差异。结论在卵巢高反应患者中,h CG扳机剂量降低至4 000 IU,既能有效的降低OHSS的发生,同时又能保证较好的IVF-ET结局。而h CG扳机剂量降低至2 000 IU,虽然OHSS发生率降低,但获卵率、卵子成熟率、受精率、2PN受精率、可利用胚胎率及优胚率等体外受精(IVF)结局也随之受影响。4 000 IU h CG是IVF-ET中卵巢高反应患者比较合适的扳机剂量。
[Abstract]:Objective to investigate in vitro fertilization and embryo transfer (IVF-ET) cycle, The optimal dose of human chorionic gonadotropin (hCG) trigger was selected for ovarian hyperreactive patients. Methods A total of 465 patients with ovarian hyperactivity were treated with IVF-ET from January 2013 to May 2014 in Xiangtan Central Hospital. According to the injection dose of hCG on the trigger day, the rats were divided into two groups: group A, group A, group A, group B, group B, group B, group C, group C, group C, group C, group C, group C, group D, the incidence of OHSSs of moderate and severe ovarian hyperstimulation syndrome (OHSS), the rate of egg acquisition and the rate of ovum maturation were compared. Fertilization rate 2PN fertilization rate, available embryo rate, excellent embryo rate and pregnancy outcome after fresh cycle transplantation. Results the rate of egg acquisition in group A was significantly lower than that in group D in other groups, and that in group D was significantly higher than that in other groups. The difference was statistically significant (78.5 vs 87.2 vs 87.8 vs 92.3%). The ovum maturation rate and 2PN fertilization rate of group A and group B were lower than those of group C and group D. the difference was statistically significant. The fertilization rate of group A was significantly lower than that of other groups. The rate of available embryos in group C was significantly higher than that in group A and group B, and was significantly lower than that in group D (67.96.2vs 76.2 vs 80.30.30.30%). The rate of excellent embryo in group D was significantly higher than that in group B (46.045.51 vs 59.2 vs 59.2). There was no difference in the incidence of severe early OHSS in group A and B. All of them were significantly lower than those in group D (0.9%, 1.8% vs 5.9%). There were no moderate or severe late-onset OHSS in group D. the rate of biochemical pregnancy in fresh cycle was higher than that in group D. There is no difference in clinical pregnancy rate. Conclusion in ovarian hyperreactive patients, the dose of hCG trigger can be reduced to 4 000 IUUs, which can effectively reduce the occurrence of OHSS. At the same time, it could ensure a good outcome of IVF-ET, and the dose of hCG trigger decreased to 2 000 IUUs. Although the incidence of OHSS was lower, the rate of egg acquisition, egg maturation, fertilization rate and fertilization rate were 2PN fertilization rate. The IVF outcome of IVF, such as embryo rate and in vitro embryo rate, was also affected. 4 000 IU hCG was the appropriate trigger dose for ovarian hyperreactive patients in IVF-ET.
【作者单位】：湖南省湘潭市中心医院生殖遗传中心;
【分类号】：R714.8

【参考文献】