摘要
目的:探讨3种促排卵方案对卵巢储备功能减退(DOR)患者胚胎发育的影响。方法:回顾性分析行体外受精-胚胎移植助孕治疗的DOR患者共140个周期的临床资料,按照促排卵方案不同分为3组,微刺激方案组40个周期、拮抗剂方案组40个周期、高孕激素下促排卵(PPOS)方案组60个周期。比较各组患者的一般资料、激素水平、促排卵及胚胎发育情况。结果:3组患者治疗后人绒毛膜促性腺激素(HCG)注射日激素水平比较,微刺激组E 2[(883.33±134.84)ng·L^(-1)]低于拮抗剂组[(993.53±110.24)ng·L^(-1)]和PPOS组[(1325.39±128.97)ng·L^(-1)](P<0.05);3组间促黄体素(LH)、孕激素(P)、临床妊娠率和活产率差异无统计学意义(P>0.05);PPOS组促排后其获卵数(5.67±1.16)、成熟(MⅡ)卵数(4.77±1.52)、正常受精数(3.27±0.86)、优胚数(2.73±0.69)和可利用胚胎数(3.00±0.88)均高于其他2组(P<0.05);拮抗剂组的MⅡ数(3.03±1.07)、正常受精数(2.25±0.78)、优胚数(1.48±0.55)、可利用胚胎数(1.73±0.60)分别高于微刺激组的[(1.58±0.59)、(1.20±0.61)、(0.75±0.44)、(0.90±0.38),P<0.05];外源性促性腺激素(Gn)用药量PPOS组[(2018.27±346.17)IU)]和拮抗剂组[(2029.17±339.44)IU]均高于微刺激组[(1680.86±309.22)IU](P<0.05)。结论:对于DOR患者,3种方案中PPOS方案胚胎结局最好,其次是拮抗剂方案。
Objective:To explore the effects of three ovulation induction protocols on the embryonic development of patients with diminished ovarian reserve(DOR).Methods:Retrospective analysis was conducted on the clinical data of 140 cycles of DOR patients undergoing IVF-ET assisted pregnancy treatment.They were divided into three groups according to different ovulation promotion schemes,including 40 cycles in the mini-stimulation scheme group,40 cycles in the antagonist scheme group,and 60 cycles in the PPOS scheme group.The general information,ovulation promotion,and embryo development of patients in each group were compared.Results:Comparison of hormone levels on the day of injection of human chorionic gonadotropin(HCG)in three groups of patients after treatment:the mini-stimulation group was lower than the antagonist group and the PPOS group(P<0.05);there were no statistically significant differences in luteinizing hormone(LH),progesterone(P),clinical pregnancy rate,and live birth rate among the three groups(P>0.05);After ovulation induction,the number of retrieved oocytes,mature(MⅡ)oocytes,normal fertilization,excellent embryos,and available embryos in the PPOS group were higher than those in the other two groups(P<0.05);the number of MⅡoocytes,normal fertilization,excellent embryos,and available embryos in the antagonist group were significantly higher than those in the mini-stimulation group(P<0.05);the dosage of exogenous gonadotropin(Gn)in the PPOS group and the antagonist group was higher than that in the mini-stimulation group(P<0.05).Conclusions:For patients with diminished ovarian reserve(DOR),the PPOS regimen had the best embryonic outcome among the three regimens,followed by the antagonist regimen.
作者
朱佳颖
王栋娜
杨璐
管瑞君
王艳
郭珍
杨红梅
甄敬辉
陈丹朔
王蔼明
ZHU Jiaying;WANG Dongna;YANG Lu;GUAN Ruijun;WANG Yan;GUO Zhen;YANG Hongmei;ZHEN Jinghui;CHEN Danshuo;WANG Aiming(Department of Reproductive Medicine,Zhuozou City Hospital)
出处
《长治医学院学报》
2023年第4期261-264,共4页
Journal of Changzhi Medical College
基金
保定市科技计划项目(1941ZF099)
吴阶平医学基金会资助项目(320.6750.2021-19-3)。
关键词
卵巢储备功能减退
PPOS方案
拮抗剂方案
微刺激方案
diminished ovarian reserve
PPOS protocol
GnRH antagonist protocol
mini-stimulation protocol
