摘要
目的比较改良降调节超长方案结合人绝经期促性腺激素(HMG)和常规降调节长方案在特殊不孕患者行体外受精/卵胞浆内单精子注射-胚胎移植术(IVF/ICSI-ET)助孕中的疗效。方法回顾分析我院2009年1月～2010年12月因子宫内膜异位症、多囊卵巢综合征及一次降调节不全的不育患者,接受IVF/ICSI-ET的治疗情况,其中5,727例采用改良降调节超长方案,9,259例采用常规降调节长方案,对2组受精率、卵裂率、临床妊娠率,着床率,流产率及宫外孕发生率等重要指标进行比较分析。结果与同期常规降调节长方案相比,改良降调节超长方案组患者的临床妊娠率显著上升(P<0.001),宫外孕发生率下降(P<0.05),同时用药天数缩短且患者治疗费用减少(P<0.05),用药量及卵巢过度刺激综合征(OHSS)风险及冻胚成功率对比无差异,注射人绒毛膜促性腺激素(hCG)日孕酮(P)水平显著降低(P<0.05)。结论对子宫内膜异位症、多囊卵巢综合征及一次降调节不全行体外受精的不育患者,采用促性腺激素释放激素激动剂(GnRH-)超长方案加人绝经期促性腺激素(HMG)是一种节约费用且成功率高的超排卵方案。
Objective：To compare the effectiveness of modified ultra-long down-regulation protocol with human menopausal gonadotropin （hMG） and routine down-regulation long protocol for controlled ovarian hyperstimulation in in vitro fertilization / intracytoplasmic sperm injection （IVF/ICSI） treatment. Methods： We retrospectively analyzed the clinical data of 5,727 patients treated with modified ultralong protocol and 9,259 patients treated with routine down-regulation long protocol during January 2009 to December 2010. The fertilization rate, cleavage rate, clinical pregnancy rate, implantation rate, abortion rate, ectopic pregnancy rate and other related parameters for above two groups were compared. Results： In modified ultra-long protocol group, the clinical pregnancy rate was significantly higher than that in routine long protocol group （57. 5% vs. 45. 3%, P〈0. 001）, while the decreased ectopic pregnancy rate （2.5% vs. 3.8%, P〈0.05）, the longer duration of gonadotropin usage （10.8±2.8 vs. 11.2±2.2, P〈0.05） and lower overall treatment cost were observed in modified ultra-long protocol group when compared to those in long protocol group. Conclusion. Modified ultra-long down-regulation protocol is effective and cost-effective in controlled ovary hyperstimulation for the patients with endometriosis, polycystic ovary syndrome or insufficient down-regulation.
出处
《生殖医学杂志》
CAS
2011年第A01期29-31,46,共3页
Journal of Reproductive Medicine
关键词
超长方案
子宫内膜异位症
多囊卵巢综合征
一次降调节不全
体外受精/卵胞浆内单精子注射一胚
胎移植
Ultra-long down-regulation protocol
Endometriosis
Polycystic ovary syndrome
Insufficient down-regulation
In vitro fertilization/intracytoplasmic sperm injection-embryo transfer
