基因重组/尿卵泡刺激素在体外受精-胚胎移植周期临床效果的比较

Comparison of the clinical effect of recombinant FSH and urinary FSH preparation on IVF-ET outcome

目的评估基因重组和尿卵泡刺激素在体外受精-胚胎移植(IVF-ET)周期中临床效果的差异。方法对单纯输卵管性因素行IVF-ET 90例患者,随机分为两组。分别给予尿卵泡刺激素(u-FSH)与基因重组卵泡刺激素(r-FSH)促排卵的结果进行比较。结果u-FSH组卵子成熟率显著高于r-FSH组(P<0.01),而平均费用、人绒毛膜促性腺激素(hCG)日血清雌二醇(E2)水平低于r-FSH组(P<0.05)。两组受精率、优质胚胎率、种植率、妊娠率、平均获卵率、促排卵天数、促性腺激素(Gn)用量、局部反应、内膜厚度差异无显著性(P>0.05)。结论在IVF-ET治疗周期中,u-FSH在不影响妊娠率的同时较r-FSH更有助于卵泡成熟,具有较大的价格优势,并有降低卵巢过度刺激综合征(OHSS)发生的趋势。因此,u-FSH有可能成为IVF-ET治疗周期中较为理想的促排卵药物。

Objective：To compare the in-vitro fertilization and embryo transfer （IVF ET） outcome in different protocols using urinary or recombinant FSH preparation. Methods：Ninety infertility patients with the only cause of salpingemphraxis undergoing IVF-ET cycles were randomly divided into 2 groups, and received either urinary FSH （u-FSH） or recombinant （r-FSH）, in combination with long GnRH-a protocol to induce ovulation. Results： The maturing rate of ooeytes in u-FSH group was significantly higher than that in r-FSH group （P〈0.05）, but the cost was higher in r-FSH group （P〈0.05）. Meanwhile, the serum estradiol （E2） levels on the day of hCG administration were lower in u-FSH group （P〈0.05）. There was no significance difference in fertilization rate, quality embryo rate, implantation rate, clinical pregnancy rate, total clays of FSH stimulation, total dose of Gn, oocyte numbers, local anaphylaxis incidence and endometrial thickness between two groups （P〉0.05）. Conclusions：u-FSH is better in ooeyte maturing with no significance difference in clinical pregnancy rate in IVF-ET treatment, and cheaper than r FSH. Theretofore, u-FSH may be desirable for the ovulation induction in IVF-ET treatment.