摘要
目的比较长方案和拮抗剂方案应用于再次接受体外受精/卵细胞浆内单精子注射(IVF/ICSI)治疗周期患者的临床效果和成本效果比。方法回顾性分析于我中心接受第2次IVF/ICSI助孕治疗患者198例,其中长方案(A组)109例,拮抗剂方案(B组)89例,分别比较两种方案的获卵数、优良胚胎数、临床妊娠率、流产率、活产率及平均总费用、成本效果比。结果在重复周期患者,两种方案组的优良胚胎数、临床妊娠率、流产率、及双胎妊娠率均无显著差异;A组临床结局好于B组,但无统计学差异。A组的活产率为20.2%,显著高于B组的9.0%,A组的获卵数为9.13±4.98枚,显著高于B组的7.11±4.74枚(P<0.05);A组平均每周期总费用均高于B组,但A组每获得一枚卵子、一枚优良胚胎和一例临床妊娠的的成本-效果比(CER)均低于B组(A组分别为2729.11、8867.19、77598.06元,B组分别为3038.60、9644.85、96139.85元)。结论对于重复IVF/ICSI周期患者,即使卵巢储备功能减退,长方案仍能获得较好的临床结局和经济效益。
Objective To compare the clinical outcomes and cost-effectiveness of luteal phase down-regulation with gonadotrophin-releasing hormone （GnRH） agonist protocol and GnRH antagonist protocol in patients undergoing repeated in vitro fertilization and intracytoplasmic sperm injection （IVF-ICSI） cycles. Methods A retrospective analysis of clinical outcomes and costs was conducted among 198 patients undergoing repeated IVF-ICSI cycles, including 109 receiving luteal phase down-regulation with GnRH agonist protocol （group A） and 89 receiving GnRH antagonist protocol （group B）. The numbers of oocytes retrieved and good embryos, clinical pregnancy rate, abortion rate, the live birth rate, mean total cost, and the cost-effective ratio were compared between the two groups. Results In patients undergoing repeated WF-ICSI cycles, the two protocols produced no significant differences in the number of good embryos, clinical pregnancy rate, abortion rate, or twin pregnancy rate. Compared with group B, group A had better clinical outcomes though this difference was not statistically significant. The number of retrieved oocytes was significantly greater and live birth rate significantly higher in group A than in group B （9.13±4.98 vs 7.11±4.74, and 20.2% vs 9.0%, respectively）. Compared with group B, group A had higher mean total cost per cycle but lower costs for each oocyte retrieved （2729.11 vs 3038.60 RMB yuan）, each good embryo （8867.19 vs 9644.85 RMB yuan）, each clinical pregnancy （77598.06 vs 96139.85 RMB yuan）. Conclusion For patients undergoing repeated IVF/ICSI cycle, luteal phase down-regulation with GnRH agonist protocol produces good clinical outcomes with also good cost-effectiveness in spite an unsatisfactory ovarian reserve.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2014年第4期563-567,共5页
Journal of Southern Medical University
基金
国家自然科学基金(30872769)~~
关键词
GNRH激动剂
GNRH拮抗剂
成本效果比
重复周期
gonadotrophin-releasing hormone agonist
gonadotrophin-releasing hormone antagonist
cost-effectiveness
invitro fertilization and intracytoplasmic sperm injection
repeated cycles
