摘要
目的:探讨滋肾调冲法和生长激素(GH)对不同年龄卵巢储备功能减退(diminished ovarian reserve,DOR)患者体外受精胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)结局的影响。方法:回顾性分析2017年1月至2019年1月在广东省妇幼保健院行IVF-ET的217例DOR患者的妊娠结局,其中年龄<35岁105例,年龄≥35岁112例,均选用拮抗剂方案且均为第一周期超促排卵。每个年龄组内,再根据预处理方式不同,分为中药组、GH组和对照组,中药组患者给予滋肾调冲法干预,GH组患者采用GH预处理,对照组患者未予中药及GH预处理。观察两个年龄组内,三组不同预处理方式患者的临床和实验室指标以及妊娠结局的差异。结果:年龄<35岁的DOR患者,添加GH后卵巢反应性和临床结局并无明显改变;中药组患者在移植日子宫内膜厚度、获卵数及两个原核(2PN)受精率方面略高于GH组和对照组,但组间比较,差异均无统计学意义(P>0.05)。年龄≥35岁的DOR患者,在Gn应用时间、Gn总量方面,GH组患者明显低于中药组和对照组;而GH组患者的优胚率明显高于中药组和对照组,上述差异均有统计学意义(P<0.05)。无论是年龄≥35岁还是年龄<35岁的患者中,中药组患者的经期子宫内膜厚度均最低,与GH组和对照组比较,差异均有统计学意义(P<0.05)。两个年龄组内,中药组、GH组和对照组患者的种植率、妊娠率及临床妊娠率比较,差异均无统计学意义(P>0.05)。结论:在高龄(年龄≥35岁)的DOR患者中加用GH可以在一定程度上改善卵巢反应性,而滋肾调冲法在年轻(年龄<35岁)的DOR患者中疗效更可观,同时滋肾调冲法可以促进经期子宫内膜剥落、使移植日子宫内膜厚度增加。
OBJECTIVE:To probe into the effects of Zishen Tiaochong method and growth hormone on outcome of in vitro fertilization and embryo transfer(IVF-ET)in women with diminished ovarian reserve(DOR)at different age.METHODS:Pregnancy outcomes of 217 patients with DOR undergoing IVF-ET in Guangdong Women and Children Hospital from Jan.2017 to Jan.2019 were analyzed retrospectively,including 105 patients<35 years old and 112 patients≥35 years old.All patients were on antagonist regimens and were on the first cycle of superovulation.controlled ovarian hyperstimulation In each age group,according to different pretreatment methods,all patients were divided into the traditional Chinese medicine group,the GH group and the control group.The traditional Chinese medicine group was given intervention of Zishen Tiaochong method,the GH group was pretreated with GH,and the control group was not pretreated with TCM or GH.Differences in clinical and laboratory indexes and pregnancy outcomes were observed in the three groups within the two age groups.RESULTS:There was no significant change in ovarian response and clinical outcome in patients with DOR aged<35 years old after GH intervention.The thickness of intrauterine membrane on the day of transplantation,number of harvested eggs and two prokaryotes(2PN)fertilization rate of the traditional Chinese medicine group were slightly higher than those of the GH group and the control group,but the difference was not statistically significant(P>0.05).For patients with DOR aged≥35 years old,the total application time and total dose of Gonadotropin(Gn)in the CH group were significanlt ly lower than those in the traditional Chinese medicine group and the control group;the optimal embryo rate in the GH group was significantly higher than that in the traditional Chinese medicine group and the control group,with statistically significant difference(P<0.05).Regardless of patients aged≥35 years old or aged<35 years old,the endometrial thickness of patients in the traditional Chinese medicine grou
作者
姚俐
黄倩文
黄莉
孙小丽
张曦倩
YAO Li;HUANG Qianwen;HUANG Li;SUN Xiaoli;ZHANG Xiqian(Dept.of Reproductive Health and Infertility,Guangdong Women and Children Hospital,Guangdong Guangzhou 511400,China;Dept.of Gynaecology,Guangdong Women and Children Hospital,Guangdong Guangzhou 511400,China)
出处
《中国医院用药评价与分析》
2021年第5期530-533,538,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
广东省中医药局科研项目(No.20191038)。
关键词
生长激素
卵巢储备功能减退
体外受精-胚胎移植
滋肾调冲法
Growth hormone
Diminished ovarian reserve
In vitro fertilization and embryo transfer
Zishen Tiaochong method
