多剂量促性腺激素释放激素拮抗剂在体外受精—胚胎移植促超排卵中的应用效果

The Use of Multiple Dosages of Gonadotropin Releasing Hormone Antagonist for COH in IVF-ET

目的探讨促性腺激素释放激素拮抗剂(GnRH-Ant)改良多剂量应用方案在体外受精-胚胎移植(IVF-ET)促超排卵中的使用效果。方法回顾性比较分析本中心2006年1～4月接受IVF-ET助孕治疗的患者中采用GnRH-Ant改良多剂量方案应用于26例年龄偏大的患者和采用促性腺激素释放激素激动剂(GnRH-a)长方案降调节方案应用于患者41例,观察其临床效果。结果两组促性腺激素的使用天数、受精率、优胚数、HCG日内膜厚度和E2值、流产率、妊娠率分别为(8.58±1.84)d和(7.71±2.06)d、88.17±17.96%和88.91±14.55%、(3.23±1.48)个和(3.78±2.31)个、(9.81±1.79)mm和(10.37±1.55)mm、(7060.27±4602.02)pmol/L和(7481.85±3852.84)pmol/L、11.54%和14.63%、50%和39.02%,两组之间比较无显著性差异;两组患者年龄、不孕年限、促性腺激素使用量、HCG日LH值、获卵数、MII卵子数分别为(34.73±15.46)和(28.76±3.08)岁、(6.54±4.11)和(4.2±2.08)年、(34.73±15.46)支和(19.32±10.45)支、(3.14±3.26)IU/L和(1.21±1.21)IU/L、(6.77±3.09)个和(9.66±3.58)个、6.23±2.79和8.88±3.60个,两组之间比较有显著性差异。结论GnRH-Ant联合促性腺激素促超排卵方案较GnRH-a长方案同样有效,尤其对于年龄较大患者比较适用,并可减轻患者的费用。

[Objective]To evaluate the efficacy of using multiple dosage of GnRH-Antagonist for COH in IVF-ET. [Methods]The clinical consequence of 77 infertile patients treated by IVF-ET was retrospectively analyzed from January to April 2006,26 of 77 cases accepted the regimen of GnRH-Antagonist and the rest accepted the long GnRH-a regimen. [Results]There was no significant difference between the two groups on the duration of treatment with gonadotropin,the rate of fertilization, the number of the good quality embryos, the endometrium thickness and the serum E2 level on the day of HCG administration and the rate of abortion and pregnancy. Otherwise there was significant difference between the two groups on the age of the patients ,the duration of the infertility ,the quantity of gonadotropin used ,the serum LH level on the day of HCG administration, the number of retrieved oocytes and the number of MII oocytes. [Conclusion]The multiple dosages of GnRH-Antagonist regimen have the same efficacy as the GnRH-a long regimen, and even more suitable for the elder patients. The treatment cost can be greatly reduced.