摘要
目的观察卵泡期长效长方案应用于卵巢低反应(POR)人群的临床特征及妊娠结局。方法回顾性分析2015年8月至2019年4月期间在我中心接受第一周期IVF/ICSI助孕、采用卵泡期长效长方案助孕的977例患者的临床资料,根据波塞冬低反应分类标准分为4组:A组(72例):年龄<35岁,抗苗勒管激素(AMH)≥1.2ng/ml,基础窦卵泡数(AFC)≥5,获卵数<10枚;B组(267例):年龄≥35岁,AMH≥1.2ng/ml,AFC≥5,获卵数<10枚;C组(238例):年龄<35岁,AMH<1.2ng/ml,AFC<5;D组(400例):年龄≥35岁,AMH<1.2ng/ml,AFC<5。比较4组的临床特征及妊娠结局。结果A组的HCG日P水平、获卵总数、2PN个数、优质胚胎数显著高于C组(P<0.05);C组的Gn用量显著低于D组,而内膜厚度、HCG日E2及P水平、获卵总数、2PN个数均显著高于D组(P<0.05);B组的Gn天数、Gn用量、HCG日LH水平及无可移植胚胎比例显著低于D组,而HCG日E2及P水平、获卵总数、2PN个数、优质胚胎数均显著高于D组(P<0.05)。各组的妊娠结局比较,A组的临床妊娠率(61.0%)、活产率(47.1%)显著高于B组(分别为30.8%和21.2%)(P<0.05);C组的临床妊娠率(57.9%)、活产率(47.4%)显著高于D组(分别为31.1%和22.2%),而流产率(15.5%)则显著低于D组(32.6%)(P<0.05)。A组与C组、B组与D组的各妊娠指标比较无显著性差异(P>0.05)。结论卵泡期长效长方案应用于年轻POR患者,可获得较满意的获卵数及妊娠结局,提示其对于卵巢储备功能下降的年轻患者仍是较理想的选择。而对于高龄POR患者,采用卵泡期长效长方案不能达到满意的妊娠结局。
Objective:To observe the clinical characteristics and pregnancy outcomes of long-acting GnRH agonist long protocol during follicular phase in patient with poor ovarian response(POR).Methods:The clinical data of 977 patients who received the first cycle of IVF/ICSI assisted pregnancy with long-acting long protocol during follicular phase in our center from August 2015 to April 2019 were retrospectively analyzed.The cycles were divided into four groups according the classification criteria of Poseidon low response:the patients<35 years with AFC≥5,AMH≥1.2 ng/ml and the oocytes retrieved<10 in group A(n=72);the patients≥35 years with AFC≥5,AMH≥1.2 ng/ml and the oocytes retrieved<10 in group B(n=267);the patients<35 years with AFC<5,AMH<1.2 ng/ml in group C(n=238),and the patients≥35 years with AFC<5,AMH<1.2 ng/ml in group D(n=400).The clinical characters and outcomes were compared among the four groups.Results:The progesterone level on HCG day,total number of oocytes retrieved,number of 2PN and number of high quality embryos in group A were significantly higher than those in group C(P<0.05).The Gn dosage in group C was significantly lower than that in group D,while the endometrial thickness,E 2 and P levels on HCG day,total number of oocytes retrieved and number of 2PN in group C were significantly higher than those in group D(P<0.05).The days of Gn,dosage of Gn,LH level on HCG day and the proportion of non-transplantable embryos in group B were significantly lower than those in group D,while the E 2 and P levels on HCG day,the total number of oocytes retrieved,number of 2PN and number of good quality embryos in group B were significantly higher than those in group D(P<0.05).The clinical pregnancy rate(61.0%)and live birth rate(47.1%)in group A were significantly higher than those in group B(30.8%and 21.2%,respectively)(P<0.05).The clinical pregnancy rate(57.9%)and live birth rate(47.4%)in group C were significantly higher than those in group D(31.1%and 22.2%,respectively)(P<0.05),while the abortion rate(
作者
代玮
胡琳莉
DAI Wei;HU Lin-li(Reproductive Medical Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou450000)
出处
《生殖医学杂志》
CAS
2019年第10期1125-1129,共5页
Journal of Reproductive Medicine
关键词
卵泡期长效长方案
卵巢低反应
波塞冬分类
Long-acting GnRH-a long protocol in follicular phase
Poor ovarian response
Poseidon classification
