不同扳机方案在卵巢储备功能减退患者中的应用

发布时间：2018-11-23 20:22

【摘要】：目的探讨促性腺激素释放激素激动剂(GnRH-a)、人绒毛膜促性腺激素(h CG)以及两者联合扳机方案在卵巢储备功能减退(DOR)患者中的应用效果。方法回顾性分析和比较DOR患者微刺激方案912例和人工黄体期方案390例中采用GnRH-a、h CG以及两者联合双扳机的临床效果。结果微刺激方案和人工黄体期方案中,h CG扳机组与双扳机组间获卵数差异均无统计学意义,但均高于GnRH-a组。微刺激方案中,h CG扳机组的受精率显著低于GnRH-a及双扳机组;人工黄体期方案中,h CG及GnRH-a扳机组的受精率显著低于双扳机组(P0.017);两种方案中,h CG联合GnRH-a扳机组的优质胚胎率均显著高于h CG扳机组和GnRH-a扳机组(P0.017);两种促排方案双扳机组的临床妊娠率均高于GnRH-a扳机组和h CG扳机组,但差异无统计学意义。结论 DOR患者的微刺激和人工黄体期方案中,h CG联合GnRH-a双扳机方案优于单纯h CG和GnRH-a扳机,可获得更多的卵母细胞和优质胚胎,改善临床妊娠率。
[Abstract]:Objective to investigate the effect of gonadotropin releasing hormone agonist (GnRH-a), human chorionic gonadotropin (h CG) and combined trigger in patients with ovarian reserve dysfunction (DOR). Methods the clinical effects of GnRH-a,h CG and double trigger in 912 patients with DOR and 390 patients with artificial luteal phase were retrospectively analyzed and compared. Results there was no significant difference in egg number between, h CG trigger group and double trigger group in microstimulation and artificial luteal phase, but they were higher than those in GnRH-a group. The fertilization rate of, h CG trigger group was significantly lower than that of GnRH-a and double trigger group, and that of, h CG and GnRH-a trigger group in artificial luteal phase was significantly lower than that of double trigger group (P0.017). The high quality embryo rate of, h CG combined with GnRH-a trigger group was significantly higher than that of h CG trigger group and GnRH-a trigger group (P0.017). The clinical pregnancy rate of double trigger group was higher than that of GnRH-a trigger group and h CG trigger group, but the difference was not statistically significant. Conclusion, h CG combined with GnRH-a double trigger is superior to h CG and GnRH-a trigger in microstimulation and artificial luteal phase in DOR patients. It can obtain more oocytes and high quality embryos and improve clinical pregnancy rate.
【作者单位】：安徽医科大学附属省立医院生殖医学中心;
【基金】：国家自然科学基金(编号:81601416)
【分类号】：R714.8

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