摘要
目的:比较PPOS方案与拮抗剂方案对卵巢低反应患者行IVF-ET助孕治疗的临床效果,探讨两种超促排卵方案在卵巢低反应(POR)患者中的疗效差异。方法:回顾分析2014年5年至2018年5月在解放军总医院第六医学中心辅助生殖医学中心行IVF-ET助孕治疗的POR患者的临床资料,根据促排卵方案不同分为PPOS组(实验组,48个周期)和拮抗剂组(对照组,67个周期)。比较两组患者的基本情况、助孕效果及妊娠结局。结果:两组患者的基本情况、基础激素水平、HCG日激素水平(FSH、P、E 2)、HCG日≥10mm卵泡数、获卵数、正常受精数、Day3优胚数、可用胚胎数、妊娠率、临床妊娠率、流产率比较,差异均无统计学意义( P >0.05)。PPOS组的HCG日血清LH水平明显低于拮抗剂组,差异有统计学意义[(2.88±2.56)mIU/ml vs (4.51±4.26)mIU/ml, P <0.05];PPOS组Gn用药总量、用药天数均多于拮抗剂组,差异有统计学意义[(2210.42±766.88)IU vs (1747.01±764.98)IU;(10.88±3.21)d vs (9.12±3.14)d, P <0.05]。PPOS方案组的获卵率、正常受精率、Day3优胚率、妊娠率、临床妊娠率与拮抗剂方案组相比无统计学差异,但总体上,均为PPOS组更理想(81.8% vs 71.1%、61.2% vs 58.2%、74.3% vs 73.2%、29.6% vs 16.3%、18.5% vs 10.5%)。PPOS组的周期取消率(14.58%)低于拮抗剂方案组(34.33%),差异有统计学意义( P <0.05)。结论: PPOS方案能更有效控制早发LH峰,使周期取消率更低,降低了治疗费用,有较好的临床价值。
Objective: To compare the clinical effect of PPOS scheme and antagonist scheme on IVF-ET assisted pregnancy treatment in patients with low ovarian response,and to explore the difference of efficacy between the two kinds of superovulation induction schemes in patients with low ovarian response. Methods: Collected data of IVF-ET assisted pregnancy at the Assisted Reproductive Medicine Center of the sixth Medical Center of the General Hospital of the Chinese people's Liberation Army from May 2014 to May 2018.The POR patients with PPOS scheme were set as group A (experimental group) to collect 48 cycles.POR patients with antagonist scheme were set up as group B (control group),and 67 cycles were collected.The basic condition,effect of assisted reproduction and pregnancy outcome of the two groups were compared. Results: Two groups of patients were compared with general information,basic hormone levels (FSH,LH,P,E 2),the blood hormone levels(FSH,P,E 2) of the HCG day,the follicle≥10mm of the HCG day,number of eggs obtained,number of normal fertilization,number of Day3 embryos,number of available embryos,pregnancy rate,clinical pregnancy rate,abortion rate,there were no statistically significant difference ( P >0.05).The blood hormone LH level of the HCG day in group A was significantly lower than that in group B[(2.88±2.56)mIU/ml vs (4.51±4.26) mIU/ml, P <0.05],and the difference was statistically significant.In the two groups,the total amount of Gn and the total number of days used of Gn were compared[( 2210.42 ±766.88)IU vs (1747.01±764.98)IU,(10.88±3.21)IU vs (9.12±3.14)IU, P <0.05].Group A was higher than group B,and the difference was statistically significant.Egg acquisition rate,normal fertilization rate,Day3 optimal embryo rate,pregnancy rate and clinical pregnancy rate of the PPOS scheme group were not statistically different from those of the antagonist scheme group,but on the whole,they were all better in the PPOS group(81.8% vs 71.1 %、61.2% vs 58.2%、74.3% vs 73.2%、29.6% vs 16.3%、18.5% vs 10.
作者
张冕
王蔼明
Zhang Mian;Wang Aiming(Department of Obstetrics and Gynecology,the Sixth Medical Center of the General Hospital of the Chinese People's Liberation Army,Beijing 100048)
出处
《现代妇产科进展》
CSCD
北大核心
2019年第9期676-680,684,共6页
Progress in Obstetrics and Gynecology
关键词
PPOS方案
拮抗剂方案
卵巢低反应
IVF-ET
Progestinprimed ovarian stimulation
Antagonist
Poor ovarian response
In vitro fertilization-embryo transfer
