黄体期长方案控制性卵巢刺激周期体外受精-胚胎移植临床分析

Clinical analysis for long protocol controlled ovarian stimulation of in vitro fertilization and embryo transfer

目的探讨黄体期GnRH-a 1.25 mg长方案控制性卵巢刺激周期体外受精-胚胎移植的临床效果。方法回顾性分析在广西妇幼保健院生殖中心实施的137个黄体期GnRH-a 1.25 mg长方案控制性卵巢刺激周期体外受精-胚胎移植(IVF-ET)资料,对比妊娠组与未妊娠组的体外受精情况,并将获卵数≤8设为1组,获卵数9～17个为2组,获卵数≥18个为3组,比较分析三组的卵巢刺激过程的内分泌变化及临床结局。结果妊娠组与未妊娠组对比获卵数差异无统计学意义(P>0.05),正常受精率差异有统计学意义(P<0.05);按三组不同获卵数分析的结果,三组年龄最小,卵巢反应性高,胚胎冷冻率较1组、2组显著升高(P<0.05),但三组单次移植周期妊娠率差异无统计学意义(P>0.05),随着获卵数增多,发生卵巢过度刺激综合征的风险明显增高(P<0.05)。结论黄体期长方案控制性卵巢刺激周期在维持一定的正常受精率的基础上可以获得满意的临床效果。

Objective To analyze the clinical effect of GrLRH - a 1.25 mg long protocol for controlled ovarian stimulation on in vitro fertilization and embryo transfer （IVF- ET）. Methods Clinical data of 137 cycles of GnRH- a 1.25 mg long protocol for controlled ovarian stimulation on IVF- ET in our reproductive center were analyzed retrospectively, and the effect of IVF in pregnancy group and nonpregnancy group was compared. According to the number of retrieved oocyte, the 137 cycles were divided into three groups： group 1 （retrieved oocyte number 48）, group 2 （ 94 retrieve oocyte number 417） and group 3 （retrieved oocyte number 918） , a comparative analysis about endocrine changes in course of ovarian stimulation and clinical outcomes among the three groups was carried out. Results The retrieved oocytes numbers between pregnancy group and non-pregnancy group had no significant difference （P〉 0.05）, while the normal fertilization rate was statistically different （P〈0. 05）. Patients in group 3 were young and had the highest ovarian response and frozen embryos rate （P〈0. 05）. However, the pregnancy rate of the single- transplant cycle among the three groups had no significantly difference （P〉0. 05）. With the retrieved ooeytes numbers increasing, the risk of ovarian stimulation syndrome was significantly increased （P〈 0. 05）. Conclusion Satisfactory clinical effects can be achieved from GnRH - a 1.25 mg long protocol for controlled ovarian stimulation cycles in conditions of normal fertilization rate.