摘要
目的探讨促性腺激素释放激素拮抗剂(GnRHant)方案中使用促性腺激素释放激素激动剂(GnRHa)联合低剂量绒促性激素(hCG)激发排卵的临床效果。方法回顾性分析270个GnRHant方案中卵巢反应正常、行新鲜胚胎移植患者的临床资料,根据激发排卵的药物将患者分为3组:hCG组、GnRHa联合低剂量hCG组、GnRHa组。观察3组的获卵数、妊娠率、流产率和卵巢过度刺激综合征(OHSS)的发生情况。结果在3组激发排卵日大卵泡数相近的情况下,GnRHa联合低剂量hCG组的获卵数显著增加。hCG组、GnRHa联合低剂量hCG组、GnRHa组的临床妊娠率分别为41.72%、59.49%、40.00%;胚胎种植率分别为23.53%、35.43%、23.40%,组间差异均有统计学意义(P<0.05);3组流产率的差异无统计学意义(P>0.05)。仅hCG组有1例轻度OHSS发生。结论 GnRHa联合低剂量hCG激发排卵能增加获卵数,改善胚胎种植率,提高妊娠率。
Objective To investigate the clinical effect of dual trigger with gonadotropin-releasing hormone agonist （GnRHa） and low-dose human chorionic gonadotropin （hCG） on oocyte maturation for normal responders. Methods Complete clinical data of 270 in vitro fertilization and embryo transfer（IVF-ET） cycles from normal responder patients with a GnRH antagonist-based ovarian stimulation protocol who were transferred with fresh embryos were retrospectively analyzed. The patients were divided into three groups based on trigger protocols： hCG group, GnRHa and low-dose hCG group,GnRHa group. The retrieved oocytes, clinical pregnancy rates, implantation and ovarian hyperstimulation syndrome （OHSS） were compared. Results The retrieved oocytes in GnRHa and low-dose hCG group significantly increased compared with the other two groups even though the number of large follicles on trigger day were similar. Clinical pregnancy rates of hCG group, GnRHa and low-dose hCG group and GnRHa group were 41.72%, 59.49% and 40.00%, respectively, which were significantly different（ all P 〈 0.05 ）. The implantation rates of hCG group, GnRHa and low-dose hCG group and GnRHa group were 23.53%, 35.43% and 23.40%, respectively, which were also significantly different（all P 〈0.05）. The miscarriage rates among the three groups were similar（P 〉0.05）. Only one woman with pregnancy in hCG group developed mild OHSS. Conclusion Dual trigger of oocyte maturation with GnRHa and low-dose hCG in normal responders can increase retrieved oocytes and improve implantation rate and pregnancy rate.
出处
《山东大学学报（医学版）》
CAS
北大核心
2014年第3期64-67,71,共5页
Journal of Shandong University:Health Sciences
关键词
促性腺激素释放激素拮抗剂
促性腺激素释放激素激动剂
绒促性激素
激发排卵
妊娠率
Gonadotropin-releasing hormone antagonist
Gonadotropin-releasing hormone agonist
Human chorionic gonadotropin
Ovulation trigger
Pregnancy rate
