摘要
目的探讨体外受精-胚胎移植(IVF-ET)中拮抗剂方案促排卵过程中使用来曲唑在卵巢储备正常群体中的应用效果。方法回顾性分析2019年1月至2020年12月于河南省人民医院生殖中心行IVF-ET助孕患者的临床资料,患者年龄<35岁,双侧窦卵泡数量(AFC)≥5个,抗米勒管激素(AMH)≥1.2μg·L^(-1)且<10μg·L^(-1),总共768周期。其中在早卵泡期使用来曲唑共311周期,为A组;在早卵泡期未使用来曲唑共457周期,为B组。比较两组之间促排卵、胚胎培养情况及妊娠结局。结果两组患者之间的一般资料差异无统计学意义(P>0.05),A组人绒毛膜促性腺素(HCG)日平均雌二醇(E_(2))水平更低,但黄体生成素(LH)及孕酮(P)水平较B组有升高趋势,差异具有统计学意义(P<0.05);A组HCG日LH峰提前率、HCG日P提前升高率均较B组高,A组与B组相比获卵数虽升高,但卵子成熟率、2PN受精率与B组相比有所降低,差异有统计学意义(P<0.05);新鲜移植周期中A组临床妊娠率较B组有下降趋势,但差异无统计学意义(P>0.05);冷冻复苏周期两组之间临床妊娠率差异无统计学意义(P>0.05);A组与B组相比累积活产率差异无统计学意义(P>0.05)。结论IVF-ET周期中拮抗剂方案促排卵添加来曲唑在卵巢储备正常人群可提高总获卵数,降低HCG日平均E_(2)水平,但对卵子成熟率、2PN受精率及新鲜周期临床妊娠率有不利影响。
Objective To investigate the use of letrozole during ovulation promotion with antagonist regimen in in vitro fertilization and embryo transfer(IVF-ET)in a group with normal ovarian reserve.Methods Clinical data of patients who underwent IVF-ET for pregnancy assistance at the Reproductive Center of the People’s Hospital of Henan Province from January 2019 to December 2020 were analyzed retrospectively.The patients were<35 years old,with bilateral antral follicle count(AFC)≥5,anti-Müllerian hormone(AMH)≥1.2μg·L ^(-1) and<10μg·L ^(-1) for a total of 768 cycles,including 311 cycles of letrozole in the early follicular phase for group A and 457 cycles without letrozole in the early follicular phase for group B.The ovulation promotion,embryo culture and pregnancy outcome were compared between the two groups.Results There was no statistical difference in the general data between the two groups(P>0.05).The mean daily estradiol(E_(2))level of human chorionic gonadotropin(HCG)was lower in group A,but the luteinizing hormone(LH)and progesterone(P)levels tended to increase compared with group B,the difference were statistically significant(P<0.05).The rate of advancement of LH peak on HCG day and the percentage of advancement of P on HCG day were higher in group A compared with group B.Although the number of eggs obtained was higher in group A compared with group B,the egg maturation rate and 2PN fertilization rate decreased compared with group B,the difference were statistically significant(P<0.05).The clinical pregnancy rate in group A tended to decrease compared with group B in the fresh transplantation cycle,but the difference was not statistically significant(P>0.05).There was no statistical difference in the clinical pregnancy rate between the two groups in the frozen resuscitation cycle(P>0.05).There was no statistical difference in the cumulative live birth rate in group A compared with group B(P>0.05).Conclusion The addition of letrozole to the antagonist regimen for ovulation in IVF-ET cycles increase th
作者
赵璐
陈圆辉
张翠莲
ZHAO Lu;CHEN Yuanhui;ZHANG Cuilian(People’s Hospital of Zhengzhou University,Reproductive Center of People’s Hospital of Henan Province,Zhengzhou 450003,China)
出处
《河南医学研究》
CAS
2022年第13期2355-2359,共5页
Henan Medical Research
基金
国家自然科学基金河南联合基金(U2004130)。
关键词
体外受精-胚胎移植
来曲唑
拮抗剂
卵巢储备
累计活产率
in vitro fertilization and embryo transfer
letrozole
antagonist
ovarian reserve
cumulative live birth rate
