摘要
目的探讨体外受精-胚胎移植(IVF-ET)后应用来曲唑联合加尼瑞克预防早发型卵巢过度刺激综合征(OHSS)的临床效果。方法选取2019年3月至2021年3月于郑州大学第二附属医院接受IVF-ET的85例患者,随机分为对照组(n=42)与研究组(n=43);取卵后,对照组使用来曲唑预防,研究组使用来曲唑联合加尼瑞克,均用药3 d。比较两组患者早发型OHSS总发生率和严重程度、助孕情况[平均获卵数、受精率、卵裂率];比较用药3 d后两组患者B超监测情况[卵巢最大直径、腹水];比较两组患者用药前和用药3 d后血清性激素水平[卵泡刺激素(FSH)、雌二醇(E2)、促黄体生成素(LH)]。结果研究组早发型OHSS总发生率(11.63%,5/43)低于对照组(28.57%,12/42),差异有统计学意义(χ^(2)=4.525,P=0.033);研究组早发型OHSS严重程度显著小于对照组(P <0.05);两组患者平均获卵数、受精率、卵裂率比较差异未见统计学意义(P> 0.05);用药3 d后,研究组患者卵巢最大长径、腹水水平均明显小于对照组(P <0.05);用药3 d后两组患者E2、FSH和LH水平均较用药前显著降低,且研究组显著低于同一时间对照组(P <0.05)。结论来曲唑联合加尼瑞克用于IVF-ET可有效预防早发型OHSS发生,降低其性激素水平且不影响助孕结局。
Objective To study the clinical effects of letrozole combined with Ganirelix to prevent early-onset ovarian hyperstimulation syndrome( OHSS) after in vitro fertilization-embryo transfer( IVF-ET). Methods A total of 85 patients who received IVF-ET in the Second Affiliated Hospital of Zhengzhou University from March 2019 to March 2021 were selected. They were randomly divided into control group( 42 cases) and study group( 43 cases). After egg collection,letrozole was used for prevention in the control group and letrozole combined with ganerik in the study group for 3 days. The total incidence and severity of early-onset OHSS and pregnancy assistance( average number of eggs,fertilization rate and cleavage rate) were compared between the two groups. B-ultrasound monitoring[maximum ovarian diameter and ascites]of the two groups after 3 days of treatment were compared. The levels of serum sex hormones [follicle stimulating hormone( FSH),estradiol( E2) and luteinizing hormone( LH) ]before and 3 days after treatment were compared between the two groups. Results The total incidence of early-onset OHSS in the study group( 5/43,11. 63%) was lower than that in the control group( 28. 57%,12/42)( χ^(2)= 4. 525,P = 0. 033). The severity of early-onset OHSS in the study group was significantly lower than that in the control group( P < 0. 05). There was no significant difference in the average number of eggs,fertilization rate and cleavage rate between the two groups( P >0. 05). After 3 days of treatment,the maximum ovarian diameter and ascites level in the study group were significantly lower than those in the control group( P < 0. 05). The levels of E2,FSH and LH in the study group were significantly lower than those in the control group at the same time( P < 0. 05).Conclusions The use of letrozole combined with ganirelix for IVF-ET can effectively prevent the occurrence of early-onset OHSS,reduce the level of sex hormones,and does not affect the outcome of assisted pregnancy.
作者
张洁
程兰兰
谭丽
Zhang Jie;Cheng Lanlan;Tan Li(Reproductive Center,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《临床医学》
CAS
2021年第10期7-10,共4页
Clinical Medicine
关键词
体外受精-胚胎移植
来曲唑
加尼瑞克
早发型卵巢过度刺激综合征
性激素水平
In vitro fertilization-embryo transfer
Letrozole
Ganirelix
Early-onset ovarian hyperstimulation syndrome
Sex hormone levels
