摘要
目的:探讨GnRH拮抗剂和激动剂对多囊卵巢综合征(PCOS)患者行体外受精-胚胎移植(IVF-ET)治疗的临床结局。方法:研究2012年7月至2012年12月行IVF-ET治疗的PCOS患者共122个周期,按照患者意愿分成A、B两组,A组54个周期采用GnRH拮抗剂方案,B组68个周期采用GnRH激动剂长方案,比较两组的促性腺激素(Gn)用药量,人绒毛促性腺激素(HCG)日激素水平,获卵率、受精率等实验室结果,卵巢过度刺激综合征(OHSS)发生率及临床结局。结果:A组的Gn总用量和用药时间分别为(1 342.82±442.56)IU和(9.67±2.06)d,显著低于B组的(1521.32±506.59)IU和(12.01±3.62)d。A组HCG日雌二醇(E2)(12 354.43±5 771.43)pmol/L,显著高于B组的(8 685.26±4 218.03)pmol/L。A、B两组受精率分别为79.3%和73.76%,囊胚形成率分别为39.33%和30.71%,A组均明显高于B组。A、B两组的临床妊娠率分别为44.90%和66.67%,B组有增高趋势但差异无统计学意义。而两组其余实验室结果,OHSS发生率及临床结局均无统计学意义。结论:与GnRH激动剂长方案相比,PCOS患者采用GnRH拮抗剂方案有效减少了Gn的用量和天数,减轻了患者的经济和心理负担,并提高了囊胚形成率,提高了累积妊娠率,是PCOS患者行IVF-ET较为适宜的促排卵方案之一。
AIM： To compare the effect of the GnRH antagonist and GnRH agonist on the out- comes of polycystic ovary syndrome patients who underwent in vitro fertilization and embryo transfer. METHODS. The study started from July 2012 to December 2012. A total of 122 pa- tients with PCOS were divided into two groups according to the will of patients. 54 cycles in group A underwent GnRH antagonist protocol and 68 cycles in group B underwent routine Gn- RH agonist protocol. The dosage of gonadotro- pin, hormone levels, laboratory results, OHSS incidence and clinical outcomes were compared between the two groups. RESULTS： Total dos- age and duration of gonadotropin of group A were （1 342.82±442.56） IU and （9.67±2.06） d, which was significantly lower than that of group B （1 521.32±506.59） IU and （12.01±3.62） days. E2 on the day of HCG administra- tion of Group A （12 354.43±5 771.43） pmol/L was significantly higher than that of group B （8 685.26±4 218.03） pmol/L. The fertilizationrate and blastocyst formation rate of group A （79.3%and 73.76%） were significantly higher compared with group B （39.3% and 30.71%）. The clinical pregnancy rates were 44.90% and 66.67% respectively. Group B had a rising trend but there had no significant difference. The oth- er laboratory results, OHSS incidence and clini- cal outcomes were not significant difference. CONCLUSION： Compared with GnRH agonist protocol, GnRH antagonist protocol effectively reduced the amount and duration of gonadotri- opin, cut down the costs and relieved the psy- chological burden. In addition, GnRH antago- nist protocol improved the blastocyst formation rate, which may indirectly increased the cumula- tive pregnancy rate. We concluded that GnRH antagonist protocol may be an alternative meth- od for PCOS patients.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2014年第7期795-800,共6页
Chinese Journal of Clinical Pharmacology and Therapeutics
