长方案添加黄体生成素对体外受精-胚胎移植结局的影响

发布时间：2018-03-24 06:20

  本文选题：黄体生成素　切入点：长方案　出处：《南方医科大学学报》2017年11期

【摘要】：目的比较在不同人群中添加黄体生成素在长方案超排卵过程中的临床结局。方法选择2010年6月~2015年12月在广州市妇女儿童医疗中心生殖医学中心进行体外受精-胚胎移植助孕的671个周期,均使用自然周期黄体期长方案促排卵,按促排卵从启动日是否添加重组黄体生成素(r-LH)分为A组(单用卵泡刺激素FSH)和B组(FSH+r-LH),再根据年龄是否小于35岁和启动日LH是否小于1.0 U/L分成4个亚组,分别比较不同亚组中是否添加LH对临床妊娠率和种植率的影响。结果两组患者在年龄、体质量指数、基础FSH、基础LH、基础雌二醇(E2)、促性腺激素剂量及天数、扳机日LH、扳机日E2、扳机日孕酮、获卵数、受精率、每卵子可用胚胎率及优胚率上均相似,差异无统计学意义,仅在扳机日内膜厚度上差异有统计学意义;亚组分析显示:对于年龄35岁且启动日LH1.0 U/L及年龄≥35岁且启动日LH≥1.0 U/L的患者,单用FSH组和FSH+r-LH组在临床妊娠率和种植率上均相似,差异无统计学意义;对于年龄35岁且启动日LH≥1.0 U/L的患者,FSH+r-LH组临床妊娠率60%,低于单用FSH组的临床妊娠率79.55%,差异有统计学意义(P0.05);对于年龄≥35岁且启动日LH1.0 IU/L的患者,FSH+r-LH组的种植率为44.74%,高于单用FSH组的种植率24.74%,差异有统计学意义(P0.05)。结论在长方案中,与单用FSH相比,添加LH并不提高获卵数、受精率及每卵子优质胚胎率;对年龄35岁即使降调节后LH水平低或年龄≥35岁但降调后LH≥1.0 U/L者添加LH并不能使患者明显获益,对于年龄≥35岁且降调后LH1.0 U/L的患者添加LH可能改善临床妊娠率和种植率,而对于年龄35岁且启动日≥LH1.0 U/L的患者应慎重选择添加外源性LH。
[Abstract]:Objective to compare the clinical outcomes of luteinizing hormone supplementation in different populations during long term hyperovulation. Methods in vitro fertilization was performed at the Reproductive Medicine Center of Guangzhou Women and Children Medical Center from June 2010 to December 2015. 671 cycles of embryo transfer. Ovulation was induced by the long luteal phase regimen. According to whether ovulation was induced by adding recombinant luteinizing hormone r-LH on the start day, group A (single follicle stimulating hormone FSHs) and group B (FSH r-LHH) were divided into four subgroups according to whether their age was less than 35 years old and whether LH was less than 1.0 U / L on the start day. Results the age, body mass index (BMI), basal FSHs, basal LHs, basal estradiol estradiol E2P, gonadotropin dose and days were compared between the two groups. LH on trigger day, E _ 2 on trigger day, progesterone on trigger day, egg number, fertilization rate, available embryo rate per egg and superior embryo rate were similar, the difference was not statistically significant, only in the thickness of intima of trigger day there was statistical significance. Subgroup analysis showed that the clinical pregnancy rate and implantation rate of FSH group and FSH r-LH group were similar to those of 35 years old and age 鈮，

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