摘要
目的:评估灵活、低剂量促性腺激素释放激素拮抗剂(Gn RH-A)方案和标准的Gn RH-A方案在卵巢储备功能减退患者体外受精-胚胎移植(IVF-ET)/卵胞质单精子注射(ICSI)的超促排卵过程中的应用价值。方法:回顾性分析108例卵巢储备功能减退患者IVF-ET周期,其中58例使用灵活而低剂量Gn RH-A方案(A组),50例使用标准Gn RH-A方案(B组)。比较各组实验室指标和临床结局。结果:A组Gn RH-A使用天数、剂量均少于B组(P<0.05);A组h CG注射日E2峰值、优质胚胎数、新鲜胚胎移植周期临床妊娠率、累积临床妊娠率均高于B组(P<0.05);但促排卵天数、Gn用量、内膜厚度、获卵数、成熟卵数、受精率、新鲜胚胎移植周期移植胚胎数、冻融胚胎移植周期临床妊娠率、累积着床率组间无统计学差异(P>0.05)。结论:与标准Gn RH-A方案相比,灵活而低剂量的Gn RH-A使用方案可获得更多的优质胚胎并降低Gn RH-A的使用总剂量和天数,提高累积临床妊娠率和胚胎着床率。
Objective： To evaluate the application of flexible gonadotrophin-releasing hormone antagonist （GnRH-A） and the standard GnRH-A protocol in patients with diminished ovarian reserve in IVF-ET. Methods： Clinical data of 108 patients undergoing IVF were retrospectively analyzed. Among them 58 patients were allocated to the flexible GnRH-A （group A） and 50 patients to the standard GnRH-A protocol （group B）. The laboratory indexes and clinical outcomes were compared between the two groups. Results： Duration and dosage of GnRH-A in group A were lower than that in group B. The E2 level on hCG injection day, No. of good-quality embryos, clinical pregnancy rate per fresh embryo transfer cycle, accumulative pregnancy rate per embryo transfer in group A were higher than those in group B （P〈0.05）. No significant differences were observed in ovarian stimulation days, Gn used dosage, endometrial thickness, No. of oocytes retrieved and mature oocytes retrieved, fertilization rate, No. of transferred embryos in fresh ET cycle, clinical pregnancy rate per frozen-thawed embryos transfer cycle, accumulative implantation rate between the two groups （P〉0.05）. Conclusion： Compared with standard GnRH-A protocol, there are more higher-quality embryos in the flexible GnRH-A protocol than those in patients with diminished ovarian reserve. At the same time, there are lower duration and dosage of GnRH-A in the flexible GnRH-A protocol compared with the standard GnRH-A protocol. Moreover, the clinical pregnancy of the flexible GnRH-A protocol were improved compared with the standard GnRH-A protocol.
出处
《生殖与避孕》
CAS
CSCD
北大核心
2015年第9期601-605,共5页
Reproduction and Contraception
基金
国家自然科学基金项目
项目号:No.81200421
