高反应患者重复长方案对卵巢反应性及妊娠结局的影响

发布时间：2018-08-06 09:48

【摘要】：目的探讨高反应患者在体外受精-胚胎移植(IVF-ET)中行重复周期垂体降调节长方案,调整治疗策略对卵巢反应性及妊娠结局的影响。方法选择南方医院生殖医学中心2008年1月~2011年12月30例高反应患者60个长方案行IVF-ET治疗不孕症的周期进行回顾性分析,比较高反应患者前后周期治疗的临床特点。结果与第一治疗周期相比,患者行重复周期治疗时年龄明显增加(P0.001),Gn启动剂量明显减少(P=0.049),h CG日雌激素(E2)水平降低(P=0.027),获卵数减少(P=0.030),优质胚胎形成率(P0.001)、临床妊娠率(P=0.009)升高,但在降调节剂量、Gn应用总量、Gn刺激时间、2原核(PN)个数、受精数、卵巢过度刺激综合征(OHSS)高危倾向周期取消率无显著性差异(P0.05),再次发生卵巢高反应者占40%(12/30)。结论对于高反应患者,行长方案重复IVF周期治疗时应注意减小Gn启动剂量,减少再次发生高反应的风险,改善助孕结局。
[Abstract]:Objective to investigate the effects of repeated cycles of pituitary hyporegulation on ovarian reactivity and pregnancy outcome in hyperreactive patients undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods from January 2008 to December 2011, 30 patients with high response were treated with IVF-ET for the treatment of infertility. The clinical characteristics of the patients with high response before and after the treatment were compared. Results compared with the first cycle, the age (P0.001) of Gn priming dose was significantly decreased (P0. 049), the level of estradiol (E2) was decreased (P0. 027), the number of oocytes was decreased (P0. 030), the rate of high quality embryo formation (P0. 001) and the clinical pregnancy rate (P0. 009) were increased. However, there was no significant difference in the number of prokaryotic (PN), the number of fertilization and the rate of canceling high risk propensity cycle of (OHSS) in ovarian hyperstimulation syndrome (P 0.05). 40% (12 / 30) of ovarian hyperresponsiveness occurred again. Conclusion for the patients with high response, we should reduce the starting dose of Gn, reduce the risk of reoccurrence of hyperreactivity and improve the outcome of assisted pregnancy during repeated IVF cycle therapy.
【作者单位】：南方医科大学南方医院妇产科生殖医学中心;南方医科大学;
【基金】：国家自然科学基金(81170575)~~
【分类号】：R714.8

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