口服避孕药预处理在体外受精-胚胎移植中的研究

The study of the effects of oral contraceptive pill pretreatment in ovarian stimulation for in vitro fertilization embryo transfer cyclesw.

目的研究促排卵周期前应用口服避孕药(OCP)在体外受精-胚胎移植(IVF)中的意义。方法回顾性分析98例行IVF的患者,按排卵周期前是否使用过OCP药物分为OCP治疗组52例和对照组46例,对入选患者的病历资料进行统计分析,评估口服避孕药对患者促排卵的效果以及对助孕结果的影响。结果OCP预处理明显减少卵巢功能性囊肿形成(P=0.0016),OCP处理组比对照组Gn天数平均增加1.29d(P=0.007),剂量平均增加492 IU(P=0.003),成熟卵率更高,但两组获卵数、受精率、流产率、临床妊娠率等差异均无统计学意义。结论OCP预处理能较好地控制促排卵的时间,有效减少医务人员周末上班时间,能使卵巢反应性得到部分改善,卵泡发育同步性更高,但Gn天数与Gn剂量较对照组增加。

Objective To assess the effects of oral contraceptive pill（OCP）pretreatment in ovarian stimulation for in vitro fertilization（IVF） using gonadotropin releasing hormone（ GnRH ） agonists. Methods Ninety-eight patients were randomized divided into group OCPs, who received OCPs pretreatment before IVF cycle （ n = 52 ）, and group B, who did not （ n = 46 ）. A retrospective analysis of the anamnestic data of the patients was carried out for the assessment of the ovulation promoting effect of OCP and their influence on the IVF- ET operation. Results The formation of ovarian cyst was significant decreased in OCPs group（ P = 0. 0016 ）. Compared with the control group,a mean of 1.29 days were increased in OCPs pretreatment group（8.52 versus 9.81 days, P = 0.007） ,and an average of 492IU gonadotropin were more consumed in OCPs group （ 2502 IU versus 2010 IU, P = 0.003）. The ratio of ovium were increased in OCPs pretreatment group（93.3% versus 87.2%, P = 0.001 ）, but no significant differences were observed regarding the number of cumulusoocyte complexes （COCs）, fertility rates, abortion rates, clinical pregnancy rates and the fertilization ratexs. Conclusion Oral contraceptive pill（OCP） pretreatment could help the doctor to control the time of ovarian stimulation, effectively reduce the work time of medical staff on weekends. It may improve the respensivity of ovary moderately and increase the synchronism of follicular development, though the duration of gonadotropin stimulation and the gonadotropin consumption were signitlcanfly increased in OCP pretreatment groups.