降调后Gn渐增法在卵巢高反应患者超促排卵周期中的应用

Pituitary down-regulation and ovulation stimulation with gradually increased gonadotropin in controlled ovarian hyperstimulation

目的探讨对高反应病人降调后Gn渐增法超促排卵的临床效果。方法回顾分析并比较2005年6月～2006年4月应用渐增法超促排卵方案的患者与对照组(应用其他促排卵方案)患者的多种临床指标。结果渐增组与对照组相比,在取卵日≥14mm卵泡数、获取卵子数、平均使用Gn天数及大卵泡穿刺率上有显著性差异,两组患者的妊娠率、使用Gn总量、取消周期率、卵巢过度刺激综合征发生率等方面均无显著性差异。结论Gn渐增法用于卵巢高反应病人的超促排卵治疗可在临床上试用。

Objective To evaluate the efficacy of ovulation stimulation protocol with gradual increment of gonadotropin in women with high ovarian response. Methods A retrospective study was conducted between june 2005 and April 2006 in 70 women undergoing controlled ovarian hyperstimulation. The clinical outcomes of the women using gradual increment protocol were compared with those of women receiving other ovulation-stimulating protocols. Results The mean number of large follicles （≥14 mm） and retrieved oocytes on the day of relrival was significantly lower, but the duration of stimulation was significantly longer in the gradual increment group than in the control group. The rate of follicular puncture was also higher in the former group. The clinical pregnancy rate, total gonadotropin dosage, cancellation rate and incidence of ovarian hyperstimulation syndrome were similar for the two groups. Conclusion Ovulation stimulation protocol with gradually increased gonadotropin may provide a promising alternative for controlled ovarian hyperstimulation in women with a strong ovarian response.