摘要
目的探讨控制性超促排卵(COH)过程中降调节后黄体生成素(LH)水平对多囊卵巢综合征(PCOS)患者体外授精/卵胞浆内单精子显微注射(IVF/ICSI)治疗结局的影响。方法回顾性分析首次接受IVF/ICSI治疗、黄体中期使用短效GnRH-α长方案垂体降调节的87例PCOS患者和同期因输卵管因素不孕接受短效GnRH-α长方案降调的277例患者,根据卵巢刺激启动日LH水平分为PCOS过度抑制组(A组,LH<1.2 U/L)与非过度抑制组(B组,LH≥1.2 U/L)、对照过度抑制组(C组,LH<1.2 U/L)与非过度抑制组(D组,LH≥1.2 U/L),分析4组患者在启动日不同血LH水平与控制性超促排卵特征及IVF临床结局的相关性。结果 A组与B组、C组与D组中垂体过度抑制者与非过度抑制者相比,垂体过度抑制者Gn用量、Gn刺激天数增加,获卵数、优质胚胎率低;A组胚胎种植率、临床妊娠率高于B组,但C组胚胎种植率、临床妊娠率低于D组(均P<0.05)。A组与C组、B组与D组中PCOS患者与对照组患者的比较中得出:PCOS患者虽然能够获取较多的卵母细胞,但受精率、胚胎种植率、临床妊娠率均无统计学差异(均P>0.05),而PCOS患者早期流产率和中度OHSS发生率显著高于对照组。结论虽然垂体非过度抑制的PCOS患者促排卵的卵巢反应性更高,但垂体过度抑制的PCOS患者有获得更佳IVF/ICSI结局的趋势。
Objective To explore the effect of luteinizing hormor,e （LH） level on tile outcome of in vitro fertilization （IVF） /intracy- toplasmic sperm injection （ICSI） ＇after pituitary down-regulation during controlled ovulation hyperstimulation （COH） in patients with polycystic ovary syndrome （PCOS） . Methods A retrospective analysis was conducted in 87 patients with PCOS and 277 patients with tubal in- fertility undergoing IVF/ICS1 for the first time after pituitary down-regulati0n using short-term effect gonadotropin-releasing hormone-α （GnRH-α） long protocol, then the patients were divided into PCOS oversuppression group （ group A, LH〈1. 2 U/L） , PCOS non-oversuppression group （group B, LH ≥ 1.2 U/L）, control oversuppression group （group C, LH〈1. 2 U/L） and control non-oversuppression group （ group D, LH ≥ 1.2 U/L） according to LH level on the starting day of ovarian stimulation. The correlations between serum LH levels on the starting day of ovarian stimulation, characteristics of COH, and the clinical outcome of IVF were analyzed in the four groups. Results Compared with group B and group D, the dose of gonadotropin （Gn） and the days of Gn stimulation increased in group A and group C, while the number of retrieved oocytes and the rate of high-quality embryos decreased （ P〈0. 05 ） . The rate of embryo implantation and clinical pregnancy rate in group A were statistically significantly higher than those in group B （ P〈0. 05 ） ; the rate of embryo implantation and clinical pregnancy rate in group C were statistically significantly lower than those in group D （P〈0. 05 ） . Compared with group C and group D, the patients in group A and group B had more oocytes, but there was no statistically significant difference in fertilization rate, embryo implantation rate, and clinical pregnancy rate （P〉0. 05 ） . However, the incidence rates of early ,abortion and moderate ovarian hyperstimulation syndrome （OHSS） in group A and group B were statistica
出处
《中国妇幼保健》
CAS
2017年第19期4764-4768,共5页
Maternal and Child Health Care of China
基金
山东省自然科学基金(ZR2012HL03)
山东省科技发展计划医药卫生项目(2011YD21014)
关键词
多囊卵巢综合征
体外受精-胚胎移植
黄体生成素
垂体抑制
长方案
Polycystic ovary syndrome
In vitro fertilization-embryo transfer
Luteinizing hormone
Pituitary suppression
Long protocol
