短效曲普瑞林不同降调节方案在体外受精/卵胞浆内单精子注射中临床效果的分析

Comparison of Clinical Effects of Different Kinds of Down-Regulation Protocols by Short-Acting Triptorelin in IVF/ICSI

目的:分析短效曲普瑞林不同降调节长方案在体外受精/卵胞浆内单精子注射(IVF/ICSI)中的临床效果。方法:回顾性分析采用长方案降调节行IVF/ICSI治疗的279个周期,根据短效曲普瑞林不同用法分为A、B两组。A组黄体中期开始隔日一次皮下注射曲普瑞林0.1mg,至月经第3天(D3)根据达到降调标准与否分为A1组(达标组)和A2组(未达标组)。A1组D3启用促性腺激素(Gn),A2组曲普瑞林改为0.1mg/d继续皮下注射,直至达到降调标准后启用Gn。B组黄体中期开始每日1次皮下注射曲普瑞林0.1mg,14d后启用Gn。比较3组的治疗效果。结果:3组曲普瑞林用量和天数均有显著统计学差异(P<0.01),A1组Gn天数多于A2、B两组(P<0.05),A1组获卵数多于B组(P<0.05),3组Gn总量、移植数、种植率、临床妊娠率均无统计学差异。结论:3种方案具有相同的临床结局,但隔日1次注射能减少曲普瑞林的用量,节约部分药费。

Objective：To compare the clinical effects of different kinds of down-regulation protocol by short-acting Triptorelin in IVF/ICSI.Methods：A retrospective analysis was performed on a total of 279 cycles.According to the frequency of injection 0.1 mg Triptorelin,patients were divided into Group A（every other day） and Group B（every day）.On the day of D3（the 3rd day of menstrual cycle）,Group A were sub-divided into two groups according to whether achieved the pituitary down regulation criterion as Group A1（achieved group） and Group A2（failed group）,and the usage of short-acting Triptorelin in Group A2 was changed to 0.1 mg/d.The gonadotropin（Gn） in group A was administrated when the pituitary down regulation criterion has been achieved,while in group B it was administrated after 0.1 mg Triptorelinla has been injected for 14 days.Results：There were significant differences among the three groups in the mean amount of triptorelin and the days to pituitary down regulation（P0.01）.The total days of Gn in group A1 were longer than in group A2 and group B（both P0.05）.The number of occytes collected in group A1 was more than in group B（P0.05）.Among the three groups,there were no statistical differences in the dosage of Gn,the number of embryo transfer,the plantation rate and the clinic pregnancy rate.Conclusion：While the three protocols have the same clinical effect,Group A is the most economical one.