卵巢慢反应患者控制性超促排卵相关因素分析:一项多中心回顾性研究

发布时间：2018-03-18 23:36

本文选题：控制性超促排卵(COH)　切入点：卵巢慢反应　出处：《中华生殖与避孕杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨控制性超促排卵(COH)过程中发生卵巢慢反应可能的相关因素。方法回顾性分析2014年1月—2016年1月期间于兰州大学第一医院、新疆佳音医院、青海省人民医院、银川市妇幼保健院、广西玉林市妇幼保健院进行促性腺激素释放激素激动剂(GnRH-a)长方案体外受精-胚胎移植(IVF-ET)的144例卵巢慢反应患者的临床资料,与132例卵巢正常反应患者(正常对照组)进行对比。结果与正常对照组相比,慢反应组患者体质量指数(BMI)、促甲状腺激素(TSH)较高,降调节及促排卵时间较长,促性腺激素(Gn)使用后7d平均卵泡直径偏小,雌二醇(E_2)、黄体生成素(LH)低,hCG注射日E_2低,IVF双原核(2PN)卵裂率较高,临床妊娠率低,差异均有统计学意义(P0.05)。患者年龄、不孕年限、基础卵泡刺激素(FSH)、LH、催乳素(PRL)、E_2、基础卵泡数、hCG注射日孕酮(P)、获卵率、胚胎质量、胚胎种植率、流产率、宫外孕率、继续妊娠率及取消移植率组间均无统计学差异(P0.05)。结论卵巢慢反应可能与患者BMI过高、甲状腺功能降低及GnRH-a过度抑制相关,较长的Gn天数仍可使慢反应患者获得较好的妊娠结局。
[Abstract]:Objective to investigate the related factors of ovarian slow response in the process of controlled hyperstimulation of ovulation (COH). Methods from January 2014 to January 2016, a retrospective analysis was made at the first Hospital of Lanzhou University, Jiayin Hospital of Xinjiang, and the people's Hospital of Qinghai Province. Clinical data of 144 patients with ovarian slow reaction in Yinchuan Maternal and Child Health Hospital and Yulin City Maternal and Child Health Hospital, Guangxi, who underwent in vitro fertilization and embryo transfer IVF-ETs with gonadotropin releasing hormone agonist (GnRH-a), a long-term gonadotropin releasing hormone agonist (GnRH-a). Results compared with the normal control group, the body mass index (BMI) and thyrotropin (TSH) of the slow response group were higher, and the time of lowering regulation and ovulation promoting were longer. The mean follicle diameter of gonadotropin Gnn was small 7 days after administration, the average follicular diameter was small, estradiol E _ 2H _ 2 and luteinizing hormone LH) were lower. The cleavage rate was higher and the clinical pregnancy rate was lower on the day of E2 low IVF double prokaryotic 2PN) on the day of injection of E2 low IVF, the difference was statistically significant (P 0.05). Basal follicle stimulating hormone (FSH), prolactin prolactin (PRL), prolactin (PRL), prolactin (PRL), prolactin (PRL), prolactin (PRL), basal follicle number (hCG), progesterone (P), egg acquisition rate, embryo quality, embryo implantation rate, abortion rate, ectopic pregnancy rate, There was no significant difference in the rate of continuous pregnancy and cancellation of transplantation between the two groups. Conclusion the slow ovarian response may be related to the high BMI, the decrease of thyroid function and the excessive inhibition of GnRH-a, and the longer days of Gn can still lead to a better pregnancy outcome in the patients with slow response.
【作者单位】：兰州大学第一医院生殖医学专科医院;新疆佳音医院;青海省人民医院;广西玉林市妇幼保健院;银川市妇幼保健院;
【分类号】：R714.8

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