生长激素添加对高龄卵巢储备功能减退患者IVF-ET妊娠结局的疗效研究

Efficacy of growth hormone supplementation on IVF-ET pregnancy outcomes in elderly patients with diminished ovarian reserve

目的探究生长激素添加对于高龄卵巢储备功能减退(DOR)患者首次IVF-ET结局的影响。方法本研究回顾性分析了从2019年5月至2020年12月在海南医学院第一附属医院生殖中心进行IVF-ET患者的资料,纳入研究对象236人并同时满足高龄(35岁≤~<40岁)和DOR的诊断标准。按照促排卵过程中是否添加生长激素(GH)将患者分为两组:118例单用促性腺激素(Gn)为对照组,118例为Gn+GH组,收集两组研究对象的获卵数、可利用胚胎数、优质胚胎率、着床率、临床妊娠率等相关妊娠结局数据并对其进行研究。结果两组病人年龄、不孕时间、体质指数(BMI)、窦卵泡数(AFC)、性激素程度、抗缪勒氏管激素(AMH)值进行对比无统计学差异(P>0.05)。两组研究对象Gn总使用计量、使用时间、扳机日P水平、扳机日子宫内膜厚度、2PN受精率、平均移植胚胎数、周期取消率等指标进行对比,无统计学差异(P>0.05)。Gn+GH组获卵数、可利用胚胎数、优质胚胎率明显优于对照组(P<0.05)。Gn+GH组着床率以及妊娠率大于对照组,但经过统计学分析后无差异性(P>0.05)。结论针对高龄(35岁≤~<40岁)卵巢储备功能减退患者,在促排卵过程中使用生长激素能够增加获卵数、可利用胚胎数以及提高优质胚胎率。

Objective To explore the effect of growth hormone(GH)supplementation on the outcome of the first IVF-ET in elderly patients with diminished ovarian reserve(DOR).Methods This study retrospectively analyzed the data of patients undergoing IVF-ET in the Reproductive Medicine Center of the First Affiliated Hospital of Hainan Medical University from May 2019 to December 2020,and included 236 subjects with advanced age(≥35 years old and<40 years old)and DOR.Patients were divided into two groups according to the GH use:118 cases of gonadotropin(Gn)alone were used in the control group,and 118 cases were in the group of both Gn and GH use,respectively.We collected the data of pregnancy outcomes about oocyte retrieval,available embryos,high-quality embryo rate,implantation rate and clinical pregnancy rate.Results There were no significant differences in age,infertility time,body mass index(BMI),antral follicle count(AFC),sex hormone levels,and anti-Müllerian hormone(AMH)values between the two groups(P>0.05).There was no significant difference between the two groups in the total amount and use time of Gn,the level of progesterone(P)plus endometrial thickness on the trigger day,2PN fertilization rate,average number of transferred embryos and cycle cancellation rate(P>0.05).The number of retrieved oocytes plus available embryos,and high-quality embryos rate in the Gn+GH group were significantly higher than those in the control group(P<0.05).The implantation rate and clinical pregnancy rate in the Gn+GH group were higher than those in the control group,but there was no significant difference between the two groups(P>0.05).Conclusion For elderly patients(≥35 years old and<40 years old)with diminished ovarian reserve,GH supplementation during ovulation induction can increase the number of retrieved oocytes plus available embryos,and high-quality embryos rate.