摘要
目的探索促性腺激素释放激素激动剂(Gn RH-a)联合人绒毛膜促性腺激素(HCG)双扳机是否有益于接受体外受精(IVF)治疗的高龄女性。方法回顾两年来不孕高龄女性在笔者所在科室接受IVF治疗的699个周期,根据扳机用药不同分为3组,即单用HCG组、单用Gn RH-a组、Gn RH-a联合HCG组。比较3组间的获卵、胚胎质量、并发症等情况,并对其后续冷冻胚胎移植(FET)周期进行分析,比较3组间妊娠结局。结果双扳机组与Gn RH-a组相似,其获卵数、成熟卵数、有效胚胎数均显著多于HCG组(P=0.000),但3组间的受精率、卵裂率、有效胚胎率比较差异无统计学意义(P>0.05)。HCG组中重度卵巢过度刺激综合征(OHSS)发生率为3.07%,而其他两组中均无发生。Gn RH-a组有获卵失败比例升高的趋势,但与其他两组差异无统计学意义(P>0.05)。不同扳机方式的后续FET妊娠结局间比较差异无统计学意义(P>0.05)。结论与传统HCG或Gn RH-a扳机方式比较,Gn RH-a联合HCG双扳机更有利于得到更多的卵子数和成熟卵数,同时避免发生诱导排卵失败、或中重度OHSS的风险。
Objective To investigate whether there are benefits of double trigger by GnRH agonist and HCG on advance-aged females receiving IVF treatment. Methods The data of 699 IVF cycles in 2 years treated for 35 and above years old women were collected retrospectively. According to the differences of trigger protocol, these cycles were divided into 3 groups：HCG group, GnRH agonist （GnRH-a） group, and Double trigger group for the protocol by using GnRH-a and HCG together. Oocytes retrieved, embryo quality, complications of treatment were compared among 3 groups, as well as the pregnancy outcomes of frozen embryo transfer （FET）. Results Double trigger and GnRH-a groups had the comparable number of oocytes, matured oocytes and viable embryos, which were both significantly higher than the number in HCG group （P=0.000）. However the rates of fertilization, cleavage and viable embryo among 3 groups were similar （P〉0.05）. No moderate or severe hyperstimulation ovarian syndrome happened in Double trigger and GnRH-a groups, while the incidence in HCG group was 3.07%. GnRH-a trigger might be accompanied by a slight but not significant higher incidence of failed oocyte retrieve （P〉0.05）. The pregnancy outcomes of FET were comparable among 3 groups （P〉0.05）. Conclusion Compared with traditional trigger protocol, the Double trigger may have benefits on more retrieved oocyte and matured oocytes. Double trigger by GnRH-a and HCG may also prevent the occurrences of the failed ovulation and severe hyperstimulation ovarian syndromes.
作者
肖宇
王旻
刘凯
Xiao Yu;Wang Min;Liu Kai(International Peace Maternity and Child Health Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)
出处
《医学研究杂志》
2018年第8期125-129,共5页
Journal of Medical Research
基金
上海市卫生和计划生育委员会临床研究专项青年项目(20184Y0289)
