妈福隆双降调在月经正常患者体外受精-胚胎移植周期中的应用

The application of Marvelon dual suppression in patients with regular menstrual cycle during in vitro fertilization treatment

目的:探讨妈福隆双降调在月经正常患者体外受精-胚胎移植助孕周期中的应用价值。方法:将172例行体外受精-胚胎移植助孕的患者随机分为两组,A组86例于月经来潮第5日服妈福隆1片1次/日共21天,服至第17片时肌注达菲林1.25mg降调节,下次月经第3～5天Gn;B组86例,阴道B超监测排卵,排卵后1周肌注达菲林1.25mg降调节,下次月经第3～5天Gn。结果:A组患者无1例发生卵巢囊肿,HCG日子宫内膜平均厚度11.2±3.1mm,妊娠率39.5%(34/86);B组6例患者发生卵泡黄素化未破裂未进入周期,8例肌注达菲林后发生卵巢囊肿,行囊肿穿刺,HCG日子宫内膜平均厚度9.3±2.9mm,妊娠率24.1%(19/79),1例降调后妊娠,但于孕2月时流产。结论:对月经正常的患者行体外受精-胚胎移植时用妈福隆双降调可减少卵巢囊肿发生、增加子宫内膜厚度、提高妊娠率。

Objective： To assess the application value of Marvelon dual suppression in patients with regular menstrual cycle during in vitro fertilization treatment. Methods： One hundred and seventy -two patients undergoing IVF -ET treatment were divided randomly into two groups. Eighty - six pat/ents in the group A were pretreated with an oral contraceptive （Marvelon） for 21 days starting on the fifth day of menstruation 1. 25 mg. Triptorelin was injected on the seventeenth day of Marvelon administration to achieve pituitary suppression. There were eithty - six patients in group B, who were detected by vaginal ultrasound scan one week after ovulation, 1. 25 mg Triptorelin was administrated without taking Marvelon. Gonadotrophin （Gn） was used from the third or fifth day of the next menstrual cycle in two groups. Results： Ovarian cyst developed in eight patients in the group B, and no patients in the group A. Six patients were cancelled for luteinizing unruptured follicle syndrome in group B, and one patient got pregnant after Triptorelin administration, but miscarriaged. There was significant difference between two groups in terms of pregnance rate, that was 39. 5% vs 24. 1%. Conclusion： Marvelon dual suppression in patients with regular menstrual cycle during in vitro fertilization treatment can add the endometrial thickness and promote pregnancy rate, abolishing ovarian cyst formation.