微刺激方案对卵巢低反应患者体外受精-胚胎移植周期治疗结局的分析

Evaluation of minimal stimulation protocol for IVF poor responders

目的探讨来曲唑/尿卵泡刺激素微刺激方案对卵巢低反应患者的治疗结局。方法研究对象为2007年7月至2009年4月在我院生殖中心接受体外受精/卵胞浆内单精子注射(IVF/ICSI)助孕的卵巢低反应患者111例,随机分为两组,60例使用微刺激方案(实验组),51例使用微量长方案(对照组)。对两组的周期取消率、获卵数、可移植胚胎数、临床妊娠率、胚胎种植率等进行比较。结果对照组与实验组的平均获卵数分别为(4.0±1.3)和(3.0±2.0)个,差异有显著性(P<0.05);两组周期取消率、可移植胚胎数、临床妊娠率、胚胎种植率差异无显著性(P>0.05)。结论来曲唑/尿卵泡刺激素微刺激方案对卵巢低反应的患者是一种有效的治疗方案,并且费用低廉。

Objective： To compare IVF outcomes between a letrozole/FSH-HP minimal stimulation protocol and a GnRH agonist mini dose long protocol for poor responders. Methods： A prospective cohort study was conducted for 111 patients who were estimated poor responders. They were randomly divided into two groups： minimal stimulation group which included 60 cycles using letrozole plus FSH-HP; GnRH-a mini dose long protocol group which included 51 cycles using low dose GnRH-a plus rFSH （or rFSH ± low dose HMG） as control. The cancellation rate, number of oocytes retrieved, transferable embryo number, clinical pregnancy rate and implantation rate were compared in the two groups. Results： More oocytes were retrieved in GnRH-a mini dose long protocol group （4.0 ± 1.3） than in minimal stimulation group （3. 0± 2. 0） and the difference was significant （P〈0. 05）. No significant difference was found between the two groups in cancellation rate, transferable embryo number, clinical pregnancy rate and implantation rate （P〉0.05）. Conclusions： The letrozole plus FSH-HP minimal stimulation protocol is effective for poor responders and is an economic protocol as well.