高效孕激素下超促排卵和微刺激方案在卵巢功能减退患者中应用效果分析

发布时间：2018-06-02 23:39

本文选题：卵巢功能减退 + 高效孕激素下超促排卵　；参考：《中国实用妇科与产科杂志》2017年05期

【摘要】：目的探讨高效孕激素下超促排卵(PPOS)和微刺激两种方案在卵巢功能减退患者(DOR)中的促排卵效果和全胚冷冻后行冻融胚胎移植(FET)的临床妊娠结局的差异。方法对2015年12月至2016年7月在郑州大学第二附属医院行体外受精-胚胎移植(IVF-ET)辅助生殖技术的431例卵巢储备功能下降患者的资料进行回顾性分析,其中PPOS方案组209例,微刺激组222例,比较两组的促排卵实验室结局和全胚冷冻后FET的妊娠结局。采用多因素Logistic回归校正混杂因素后比较两种促排卵方案的临床妊娠率。结果 PPOS组扳机日促黄体生成素(LH)水平低于微刺激组[3.63(2.40,5.46)U/L vs.7.07(4.04,11.92)U/L,P0.05],PPOS组取消取卵率低于微刺激组(1.44%vs.7.21%,P0.05),PPOS组获卵数、可利用胚胎数和优质胚胎数均高于微刺激组(P0.05)。全胚冷冻后行复苏移植,PPOS组临床妊娠率(29.17%)和胚胎着床率(14.63%)略高于微刺激组(19.70%和12.59%,P0.05)。多因素Logistic回归分析结果显示:PPOS方案可以获得更高的临床妊娠率(OR=6.79,95%CI 1.15~40.06,P=0.035)。结论对于DOR患者,PPOS方案较微刺激方案可减少取消取卵率,并可获得更多的获卵数、可利用胚胎数和优质胚胎数,累积胚胎提供更多移植机会。PPOS方案可作为DOR患者行IVF-ET辅助生殖技术时促排卵方案的一种选择。
[Abstract]:Objective to investigate the effects of high effective progesterone hyperstimulation (PPOS) and microstimulation on ovulation promotion in patients with ovarian hypofunction and the clinical pregnancy outcome of frozen and thawed embryo transfer (FETs). Methods from December 2015 to July 2016, the data of 431 patients with ovarian reserve dysfunction who were treated with IVF-ET-assisted reproductive technique in the second affiliated Hospital of Zhengzhou University were analyzed retrospectively, including 209 cases in PPOS group. The ovulation stimulating laboratory outcome and the pregnancy outcome of FET after cryopreservation were compared in the microstimulation group (222 cases). Multivariate Logistic regression was used to correct the confounding factors and to compare the clinical pregnancy rate of two ovulation promotion protocols. Results the level of daily luteinizing hormone in PPOS group was lower than that in microstimulation group [3.63 卤2.405.46 UL / L vs.7.07 4.0411.92 U / L P 0.05] the rate of canceling eggs was lower than that of microstimulation group (1.44vs.7.21). The number of embryos available and the number of high-quality embryos were higher than that of microstimulation group (P0.05). The clinical pregnancy rate (29.17) and embryo implantation rate (14.63) in PPOS group after cryopreservation were slightly higher than those in micro-stimulation group (19.70% and 12.59% P 0.05). The results of multivariate Logistic regression analysis showed that a higher clinical pregnancy rate could be obtained by using the 1: PPOS regimen. Conclusion compared with the microstimulation regimen, the DOR regimen can reduce the rate of removing eggs, and obtain more eggs, and can make use of the number of embryos and the number of high-quality embryos. Cumulated embryos provide more transfer opportunities. PPOS regimen can be used as an alternative for ovulation promotion in DOR patients with IVF-ET assisted reproductive technology.
【作者单位】：郑州大学第二附属医院生殖医学部;
【分类号】：R714.8

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