双刺激方案与微刺激并拮抗剂方案在卵巢储备功能下降患者中的应用

发布时间：2019-05-18 10:49

【摘要】：目的探讨双刺激方案以及微刺激并拮抗剂方案在卵巢储备功能下降(DOR)患者体外受精-胚胎移植(IVFET)中的应用。方法对283例DOR患者进行回顾性分析,其中双刺激方案204例,拮抗剂方案79例,比较各方案的促排卵结局。结果双刺激方案黄体期促排卵的获卵数、可用胚胎数、优质胚胎数、促排天数及用量、扳机日孕酮(P)值均高于卵泡期促排,扳机日黄体生成素(LH)水平低于卵泡期促排。拮抗剂方案获卵数、优质胚胎数、促排天数和用量高于双刺激卵泡期促排,扳机日LH值低于双刺激卵泡期促排,两组可用胚胎数差异无统计学意义。双刺激黄体期促排天数和用量、扳机日雌二醇(E2)、P值高于拮抗剂组,扳机日LH值低于拮抗剂组,两组获卵数、可用胚胎数、优质胚胎数差异均无统计学意义。3组促排卵周期取消率、获卵率、获可用胚胎率差异无统计学意义。双刺激方案两期促排卵之后获可用胚胎率较拮抗剂方案高,流产率较低。结论双刺激增加的黄体期促排卵在DOR患者中的应用与微刺激联合拮抗剂方案有相同的临床结局,在同一个月经周期中进行双刺激方案缩短了IVF-ET的治疗时间,对于DOR患者是一种可行的方案。
[Abstract]:Objective To investigate the application of dual stimulation and microstimulation and antagonist in in-vitro fertilization-embryo transfer (IVFET) in patients with a decrease in ovarian reserve function (DOR). Methods A retrospective analysis of 283 patients with DOR was performed, including 204 cases of double stimulation,79 of the antagonist, and the result of the stimulation of each regimen. Results The number of oocytes, the number of available embryos, the number of high-quality embryos, the number of days and the dosage of the stimulation, the progesterone (P) value of the trigger was higher than that of the follicular phase, and the level of the luteinizing hormone (LH) on the trigger was lower than that of the follicular phase. The number of oocytes, the number of high-quality embryos, the number of growth-promoting days and the dosage of the antagonist are higher than that of the double-stimulation follicular phase, and the LH value of the trigger day is lower than that of the dual-stimulation follicular phase, and the difference of the number of available embryos in the two groups is not statistically significant. In the two groups, the number of ovulation and the dosage of the two groups were higher than that of the antagonist group. The LH value of the trigger day was lower than that of the antagonist group. The number of eggs, the number of available embryos and the number of the high-quality embryos of the two groups were not statistically significant. There was no significant difference in the rate of available embryos. After two-stage stimulation of the two-stimulation scheme, the available embryo rate is higher than that of the antagonist, and the abortion rate is low. Conclusion The application of double-stimulation to the stimulation of ovulation in the patients with DOR has the same clinical outcome in the case of the combination of the microstimulation and the combination of the antagonist. In the same menstrual cycle, the double-stimulation scheme has shortened the treatment time of IVF-ET, and it is a feasible solution for DOR patients.
【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:81370757)
【分类号】：R714.8

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