在低卵巢储备患者中灵活的促性腺激素拮抗剂方案优于标准拮抗剂方案

发布时间：2018-02-21 08:16

本文关键词： 体外受精-胚胎移植(IVF-ET) 促性腺激素释放激素拮抗剂(GnRH-A) 卵巢低反应累积妊娠率　出处：《生殖与避孕》2015年09期 　论文类型：期刊论文

【摘要】：目的:评估灵活、低剂量促性腺激素释放激素拮抗剂(Gn RH-A)方案和标准的Gn RH-A方案在卵巢储备功能减退患者体外受精-胚胎移植(IVF-ET)/卵胞质单精子注射(ICSI)的超促排卵过程中的应用价值。方法:回顾性分析108例卵巢储备功能减退患者IVF-ET周期,其中58例使用灵活而低剂量Gn RH-A方案(A组),50例使用标准Gn RH-A方案(B组)。比较各组实验室指标和临床结局。结果:A组Gn RH-A使用天数、剂量均少于B组(P0.05);A组h CG注射日E2峰值、优质胚胎数、新鲜胚胎移植周期临床妊娠率、累积临床妊娠率均高于B组(P0.05);但促排卵天数、Gn用量、内膜厚度、获卵数、成熟卵数、受精率、新鲜胚胎移植周期移植胚胎数、冻融胚胎移植周期临床妊娠率、累积着床率组间无统计学差异(P0.05)。结论:与标准Gn RH-A方案相比,灵活而低剂量的Gn RH-A使用方案可获得更多的优质胚胎并降低Gn RH-A的使用总剂量和天数,提高累积临床妊娠率和胚胎着床率。
[Abstract]:Objective: to assess flexibility, Application value of low dose gonadotropin releasing hormone antagonist (Gn RH-A) regimen and standard Gn RH-A regimen in the process of hyperstimulation of ovulation in patients with ovarian reserve dysfunction by IVF-ETT / ICSI. Methods: IVF-ET cycles in 108 patients with ovarian reserve dysfunction were retrospectively analyzed. Among them, 58 cases were treated with flexible and low dose Gn RH-A regimen. 50 cases were treated with standard Gn RH-A regimen. The laboratory indexes and clinical outcome of each group were compared. Results the dosage of Gn RH-A in group A was less than the peak value of E 2 in group B for h CG injection. The number of high quality embryos, the clinical pregnancy rate of fresh embryo transfer cycle and the cumulative clinical pregnancy rate were higher than those of group B, but the dosage of Gn, the thickness of endometrium, the number of eggs obtained, the number of mature eggs, the rate of fertilization and the number of embryos transferred during the period of fresh embryo transfer were higher than those of group B. There was no significant difference in clinical pregnancy rate and cumulative implantation rate between frozen and thawed embryo transfer cycles (P 0.05). Conclusion: compared with the standard Gn RH-A regimen, there is no significant difference in clinical pregnancy rate and cumulative implantation rate between the two groups. The flexible and low dose of Gn RH-A can obtain more high quality embryos, reduce the total dose and days of Gn RH-A use, and increase the cumulative clinical pregnancy rate and embryo implantation rate.
【作者单位】：广东省第二人民医院生殖医学中心;
【基金】：国家自然科学基金项目,项目号:No.81200421
【分类号】：R714.8

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