人工黄体期促排方案治疗卵巢储备功能低下患者的实验室结局

Laboratory outcome of artificial luteal-phase ovarian stimulation protocol in treatment of patients with diminished ovarian reserve

目的探讨人工黄体期方案用于卵巢储备功能低下患者促排卵治疗的可行性及有效性。方法收集2016年5月至2017年4月在安徽省立医院行辅助生殖技术助孕的449例卵巢储备功能低下(DOR)患者的临床资料,根据促排卵方案的不同把应用人工黄体期促排卵方案245例患者设为观察组,把应用微刺激促排卵方案204例患者设为对照组;比较两组患者的年龄、促排周期数、基础血清卵泡刺激素(FSH)、雌二醇(E2)及孕酮(P)水平、获卵数、成熟卵数、正常受精数、优质胚胎数以及周期取消率、正常受精率、优质胚胎率的差异。结果观察组的总周期取消率为25.71%低于对照组34.8%,差异有统计学意义(P=0.036);观察组获卵数(3.18±2.65)个、成熟卵数(2.93±2.49)个均高于对照组(2.74±2.27)个、(2.51±2.14)个,但差异均无统计学意义(获卵数P=0.059,成熟卵数P=0.058);观察组的优质胚胎数(1.50±1.69)个及优质胚胎率69.04%均高于对照组(1.19±1.32)个、60.65%,差异均有统计学意义(优质胚胎数P=0.027,优质胚胎率P=0.008);但正常受精数及正常受精率两组间比较,差异均无统计学意义(P>0.05)。结论人工黄体期促排卵方案对于DOR患者,可行有效,是一种较好的促排卵选择。

ObjectiveTo explore the feasibility and efficacyof ovulation inductiontherapy withartificial luteal-phase protocol in the treatment of patients with diminished ovarian reserve(DOR).MethodsTheclinical data of449DOR patients,underwent assisted reproduction treatment in our center from May2016to Apr2017,were collected and245cases with artificial luteal-phase ovarian stimulationprotocolwere assigned to the study group,other204cases with different protocol of mild ovarian stimulationwere divided into the control group.Then differences between the two groups in their age,times ofovarian stimulation,basal serum levels of follicle-stimulating hormone(FSH),estradiol(E2)and progesterone(P),numbers of retrieved oocytes,mature oocytes,fertilized oocytes andhigh-quality embryos,together with rates ofcycle cancellation,normal fertilization and high-quality embryos,were compared.ResultsThetotal cycle cancellation rate in the study group(25.71%)was significantly lower than that in the control group(34.8%)(P=0.036).Moreover,the number of retrieved oocytes and mature oocytes in the study group(3.18±2.65;2.93±2.49)werehigher than those in the control group(2.74±2.27;2.51±2.14),but no significant difference was found between the two groups(P=0.059;P=0.058).Although the number and rate of high-quality embryos in the study group(1.50±1.69;69.04%)were higher than those in the control group(1.19±1.32;60.65%),with significant differencesbetween the two groups(P=0.027;P=0.008),but differences in the number and rate of normal fertilizationbetween them were of no significance(P>0.05).ConclusionFor those DORpatients,theartificial luteal-phase ovarian stimulationprotocol might be more feasible and effective,and could be applied as a betteroption ofovulation induction.