摘要
目的对比不同控制性超排卵方案对超重及肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者体外受精-胚胎移植(IVF-ET)的治疗效果。方法回顾性分析2010年1月至2013年8月行IVF助孕的体质指数(body mass index,BMI)≥25.0 kg/m2的PCOS患者179例,按照促排卵方案的不同分为促性腺激素释放激素激动剂(Gn RH-a)长方案组和Gn RH拮抗剂(Gn RH-ant)组,比较两组患者的基本情况和治疗周期中各参数及IVF/ICSI-ET助孕结局。结果 Gn RH-a长方案组促性腺激素(gonadotropin,Gn)用药天数[(10.48±2.07)d vs.(9.07±1.78)d,P=0.032]、Gn总量[(2 411.2±1 286.3)IU vs.(2 204.4±800.2)IU,P=0.036]、获卵数(16.07±7.28 vs.13.74±7.34,P=0.011)、受精率[(77.1±2.0)%vs.(70.0±1.1)%,P=0.041]、着床率(26.4%vs.21.4%,P=0.041)及冷冻胚胎数(7.9±0.5vs.6.1±0.4,P=0.037)明显高于Gn RH-ant组,而临床妊娠率低于Gn RH-ant组(30.2%vs.35.6%,P=0.031)。结论对于超重及肥胖型PCOS患者,与黄体中期长方案相比,拮抗剂方案Gn用量少,临床妊娠率高,更为经济有效,在制定个体化的促排卵方案时可优先考虑。
Objective To evaluate the clinical outcome of in vitro fertilization-embryo transfer （IVF-ET） of differ-ent controlled ovarian hyperstimulation （COH） protocols on overweight and obese patients with polycystic ovary syndrome （PCOS）. Methods One hundred and seventy nine cases of overweight and obese PCOS patients （BMI≥25.0 kg/m2） under-went IVF/ICSI-ET during 2010 to 2013 were recruited into this study. The general characteristics, COH and clinical out-comes were analyzed in the groups of gonadotropin releasing hormone agonist （GnRH-a） and GnRH antagonist （GnRH-ant）, retrospectively. Results The duration of Gn administration [（10.48 ±2.07）d vs. （9.07 ±1.78）d, P= 0.032] dosage of Gn administration [（2 411.2±1 286.3）IU vs. （2 204.4±800.15）IU, P=0.036], the retrieval oocytes （16.07±7.28 vs. 13.74±7.34, P= 0.011）, fertilization rate [（77.1±2.0）% vs. （70.0±1.1）%,P= 0.041], implantation rate （26.4% vs. 21.4%, P=0.041）, and frozen embryo number （7.9±0.5 vs. 6.1±0.4, P=0.037） of the GnRH-a group were significantly higher than other groups （P〈0.05）. However, the clinical pregnancy rate （30.2%vs. 35.6%,P=0.031） of the GnRH-a group was sig-nificantly lower than that of the GnRH-ant group （P〈0.05）. Conclusion Compared with the GnRH-a long protocol, for obese PCOS patients, the less Gn dosage, the higher clinical pregnancy rate and more economical in the GnRH-ant group. Therefore, it is preferred in COH.
出处
《北京医学》
CAS
2014年第11期909-912,共4页
Beijing Medical Journal
基金
国家自然科学基金(81170542)
北京市卫生系统高层次卫生技术人才培养项目(2011-3-071)
首都医科大学附属北京妇产医院学科带头人项目(2013-2)
关键词
多囊卵巢综合征
体质指数
体外受精-胚胎移植
控制性促排卵
Polycystic ovary syndrome （PCOS） BMI In vitro fertilization-embryo transfer （IVF-ET） Con-trolled ovarian hyperstimulation（COH）
