人绒毛膜促性腺激素注射日应用促性腺激素对体外受精结局的影响

Effect of gonadotrophin application on the day of hCG administration on in vitro fertilization outcome

目的探讨人绒毛膜促性腺激素(hCG)注射日继续使用促性腺激素(Gn)对体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾分析2006年1～12月541例采用促性腺激素释放激素-a(GnRH-a)长方案控制性超促排卵资料,根据hCG注射日是否继续使用Gn分为Gn组和停用Gn组。结果使用Gn组的获卵数(11.57±6.64)显著高于停用Gn组(10.17±6.13)、胚胎利用率(82.28%)低于停用Gn组(87.87%),差异均有统计学意义(P<0.05)。两组hCG注射日优势卵泡数和雌二醇(E_2)水平、卵母细胞成熟率、优质胚胎率、移植胚胎数、冷冻胚胎数、ET日E_2水平、hCG日与ET日E_2比值、临床妊娠率、累计妊娠率以及卵巢过度刺激综合征(OHSS)发生率均无统计学差异(P>0.05)。结论 hCG注射日继续使用Gn虽然可以增加获卵数,但并未改善妊娠结局,因此不主张hCG注射日继续使用Gn。

Objective： To study the effect of gonadotropin （Gn） application on the day of hCG administration on in vitro fertilization （IVF） outcome. Methods： The data of 541 patients who adopted GnRH-a long-protocol of controlled ovarian hypers- timulation from Jan. 2006 to Dec. 2006 were analyzed retrospectively. The patients were divided into two groups according to the application of Gn or not on the day of hCG administration. Results： The number of oocytes retrieved in On group was significantly higher than that in the other group （P〈0.05）, while the rate of embryo utilization was lower （P〈0.05）. There were no significant differences between the two groups in the number of dominant follicles, the serum E2 levels on the day of hCO administration （day-of-hCO E2）, the oocyte maturation rate, the high quality embryo rate, the numbers of embryo transferred and frozen, the serum E2 levels on the day of embryo transfer （day-of-ET E2）, the ratio of day-of-hCG E2 to day-of-ET E2, the clinical pregnancy rate, the cumulative pregnancy rate and the OHSS rate （P〉0. 05）. Conclusions： Application of Gn on the day of hCG administration can increase the number of oocytes retrieved, but it can＇t improve the pregnancy outcome. So it is not recommended to use Gn on the day of hCG administration.