摘要
目的 探索拮抗剂方案和高孕激素状态下促排卵(PPOS)方案对符合波塞冬(POSEIDON)分类标准中预期低预后人群的促排卵结局。方法 回顾性分析2016年9月1日至2022年6月1日就诊于淄博市妇幼保健院生殖医学中心、符合POSEIDON标准预期低预后患者的临床资料(共111例患者,149个促排卵周期)。根据促排卵方案不同分为拮抗剂组(69个周期)和PPOS组(80个周期),比较两组患者的一般资料及促排卵实验室指标;又按照年龄不同分为低龄组(年龄<35岁,POSEIDON标准组3,共53个周期)和高龄组(年龄≥35岁,POSEIDON标准组4,共96个周期),分析不同年龄分层中不同促排卵方案下的促排卵结局。结果 拮抗剂组中1个周期因卵泡早排未取卵,12个周期无可利用胚胎;PPOS组中3个周期未获卵,20个周期无可利用胚胎。拮抗剂组和PPOS组的一般资料比较均无显著性差异(P>0.05);拮抗剂组Gn天数及Gn用量均显著低于PPOS组(P<0.05),HCG日LH水平显著高于PPOS组(P<0.05);两组间获卵总数、正常受精率、可移植胚胎率、优胚率、卵泡早排率、未获卵率、无可移植胚胎率比较均无显著性差异(P>0.05)。低龄组患者中拮抗剂组Gn用量、获卵总数、成熟卵子数、2PN数、优胚数均显著低于PPOS组(P<0.05),拮抗剂组HCG日LH水平显著高于PPOS组(P<0.05);高龄组患者中拮抗剂组Gn用量显著低于PPOS组(P<0.05),其余指标均无显著性差异(P>0.05)。结论 拮抗剂方案和PPOS方案应用于POSEIDON标准预期低预后患者,二者可获得相似的促排卵结局。对于低龄预期低预后患者可优先考虑PPOS方案;而对于高龄预期低预后患者,在考虑时间与经济成本方面,拮抗剂方案可能优于PPOS方案。
Objective:To explore the effect of GnRH antagonist protocol and progestin-primed ovarian stimulation(PPOS)protocol on the ovarian stimulation outcome in the low prognosis patients according to POSEIDON classification criteria.Methods:The clinical data of 111 patients(149 cycles)with low prognosis according to POSEIDON standard in the Reproductive Medical Center of Zibo Maternal and Child Health Care Hospital from September 1,2016 to June 1,2022 were retrospectively analyzed.According to different ovulation induction protocols,they were divided into antagonist group(69 cycles)and PPOS group(80 cycles).The general data and laboratory indexes of ovulation induction were compared between the two groups.They were also divided into the younger group(age<35 years old,POSEIDON standard groupⅢ,53 cycles)and the older group(age≥35 years old,POSEIDON standard groupⅣ,96 cycles)according to their age.The outcomes of ovulation induction under different ovarian stimulation protocols in different age groups were analyzed.Results:In the antagonist group,there was one cycle without oocytes retrieved due to early ovulation of follicles,12 cycles with no embryos available.There were 3 cycles without oocytes retrieved and 20 cycles with no embryos available in the PPOS group.There was no significant difference in general data between antagonist group and PPOS group(P>0.05).The days and doses of gonadotropin(Gn)in the antagonist group were significantly less than those in PPOS protocol group,while the LH levels were significantly higher than that of PPOS group(P<0.05).There were no significant differences in the total number of oocytes retrieved,normal fertilization rate,transferable embryo rate,excellent embryo rate,early ovulation of follicles rate,no oocyte retrieved rate,and no transferable embryo rate between the two groups(P>0.05).In the younger group,the amount of Gn,number of oocytes retrieved,number of mature oocytes,number of 2PN embryos and number of excellent embryos in the antagonist group were significantly less th
作者
张睿
孙玉华
孙玉琴
ZHANG Rui;SUN Yu-hua;SUN Yu-qin(Zibo Maternal and Child Health Care Hospital,Zibo 255029)
出处
《生殖医学杂志》
CAS
2023年第5期677-684,共8页
Journal of Reproductive Medicine
关键词
波塞冬标准
卵巢低反应
拮抗剂方案
高孕激素状态下促排卵方案
POSEIDON classification
Poor ovarian response
GnRH antagonist protocol
Progestin-primed ovarian stimulation(PPOS)protocol
