微刺激方案治疗卵巢低反应IVF周期的疗效和经济学评价

Therapeutic Efficiency and Economic Evaluation of Minimal Stimulation Protocol in the Treatment of Ovarian Poor Responders

目的:评价微刺激方案应用于卵巢低反应患者促排卵中的效果及医疗成本。方法:回顾性分析在我中心行IVF/ICSI助孕的卵巢低反应患者86例,其中微量长方案(A组)53例,微刺激方案(B组)33例,比较2种方案的妊娠结局及费用。结果:A组的周期取消率为7.55%,每刺激周期临床妊娠率为30.2%,流产率为6.3%;B组则分别21.21%、24.2%和25.0%,组间比较差异无统计学意义(P>0.05)。A、B组均无宫外孕发生。A组的每周期总费用为17 930±3 628元,B组为5 654±2 083元,两者相比差异有统计学意义(P<0.05)。B组每获得1例临床妊娠所耗费的成本为23 324.4元,明显低于A组的59 392.7元。结论:微刺激方案治疗卵巢低反应者疗效好、经济效益高。

Objective： To evaluate the cost-effectiveness of minimal stimulation protocol on poor responders. Methods： A total of 86 cycles of poor responders were assigned to GnRHa mini dose long protocol group （group A, 53 cycles） and minimal stimulation protocol group （group B, 33 cycles）. The main outcome measures were clinical outcome and costs per clinical pregnancy. Results： There was no significant difference in group A and group B in the cancellation rate, clinical pregnancy rate and abortion rate （7.55% vs 21.21%, 30.2% vs 24.2%, 6.3% vs 25.0%）. No ectopic pregnancy occurred in this research. The cost per cycle of group A was 17 930 ± 3 628 RMB, significantly higher than that of group B （5 654 ± 2 083 RMB）. The cost-effectiveness of group B per clinical pregnancy was 23 324 RMB, which was significantly lower than that of group A （59 393 RMB）. Conclusion： Minimal stimulation protocol results in good outcome and cost-effectiveness.