改良超长方案中促排卵时不同时期添加高纯度尿促性素对助孕结局的影响

发布时间：2018-07-24 21:21

【摘要】：目的 探讨促性腺激素释放激素激动剂(GnRH-a)改良超长方案促排卵中高纯度尿促性素(HPhMG)不同添加时机和剂量对助孕结局的影响。方法 回顾性分析本中心首次行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)中采用改良超长方案并添加使用了HP-hMG的454例患者的临床资料,根据添加HP-hMG的时机分为全程添加组(A组)和后半期添加组(B组)。A组:Gn启动日血清黄体生成素(LH)1.2 IU/L的患者在重组卵泡刺激素(r-FSH)促排卵的第1日同时添加HP-hMG至hCG注射日;B组:Gn启动日血清LH≥1.2 IU/L的患者r-FSH促排卵的第6日开始添加HP-hMG至hCG注射日。对不同年龄阶段患者(≤35岁和36~40岁)进行分析,观察Gn使用总量和使用时间、hCG注射日激素水平、获卵情况、胚胎质量、着床率、临床妊娠率、活产率、流产率和中重度卵巢过度刺激综合征(OHSS)风险等临床结果。结果 ≤35岁的患者中A组相比B组,虽然Gn使用总量有所增加,但hCG注射日孕酮(P)水平降低,IVF受精率明显增高,差异均有统计学意义(P0.05);着床率分别为58.2%和42.4%,临床妊娠率分别为80.1%和61.7%,活产率分别为68.9%和49.5%,差异均有统计学意义(P0.05)。36~40岁的患者中,A组与B组的临床妊娠率分别为61.9%和26.3%,活产率分别为47.6%和15.8%,差异均有统计学意义(P0.05)。A、B两组在不同年龄段的流产率和中重度OHSS发生率相似。结论 改良超长方案中患者全程添加HP-hMG较后半期添加能降低hCG注射日P水平,显著提高着床率、临床妊娠率和活产率。
[Abstract]:Objective to investigate the effect of different time and dosage of high purity urotropin (HPhMG) (HPhMG) on outcome of assisted pregnancy in a modified super long protocol of gonadotropin releasing hormone agonist (GnRH-a). Methods the clinical data of 454 patients who underwent in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for the first time and were treated with HP-hMG were analyzed retrospectively. Patients with serum luteinizing hormone (LH) 1.2 IU/L) were divided into two groups according to the timing of HP-hMG addition (group A) and group B (group B) in the second half of the period. Patients with serum luteinizing hormone (LH) 1.2 IU/L) were injected with HP-hMG into hCG on the first day of ovulation induced by recombinant follicle stimulating hormone (r-FSH). On the 6th day of r-FSH ovulation in patients with LH 鈮，

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