短方案和微刺激方案在卵巢低反应助孕患者中的应用研究

The clinical research of application about short programs and mini-stimulation protocols in the assisted reproduction patients of poor ovarian response

目的探讨卵巢低反应助孕患者在进行体外受精-胚胎移植(IVF-ET)治疗中微刺激方案和短方案的应用价值。方法将2009年1月至2010年12月首次在江西省妇幼保健院生殖中心接受IVF/ICSI-ET治疗并预测卵巢低反应的121例患者分为微刺激方案(57例,微刺激组)和短方案(64例,短方案)组。比较两组的周期取消率、hCG注射日子宫内膜厚度、血LH、E2、P水平,以及平均获卵数、MⅡ卵率、着床率和临床妊娠率。结果微刺激组的周期取消率高于短方案组,差异有统计学意义(P<0.05)。微刺激组Gn天数低于短方案组,微刺激组hCG日LH值高于短方案组,差异均有统计学意义(P<0.01)。微刺激组hCG日P值高于短方案组,但差异无统计学意义(P>0.05)。微刺激组hCG日E2值、子宫内膜厚度和获卵数均低于短方案组,差异有统计学意义(P<0.05)。微刺激组MⅡ卵率和临床妊娠率低于短方案组,着床率高于短方案组,但差异均无统计学意义(P>0.05)。结论微刺激方案是卵巢低反应患者较理想的促排卵方案。

Objective To explore the effection of mini-stimulation protocols and short programs on patients of poor ovarian responders in vitro fertilization and embryo transfer（IVF-ET）.Methods 121 patients who received IVF/ICSI-ET treatment in Reproductive Center of Child and Women Health Hospital of Jiangxi Province from the January 2009 to December 2010 for the first time were randomly divided into mini-stimulation protocols group and short programs group.Parameters of cycle cancellation rate,the endometrial thickness,serum LH,E2,P levels on the day of hCG injection,the average number of oocytes retrieved,MⅡ egg cleavage rate,implantation rate and clinical pregnancy rate were compared between the two groups.Results The cycle cancellation rate of mini-stimulation protocol group（MS group）was significant higher than that of short programs group（SP group）（P0.05）.The Gn days in SP group was more than that in MS group,LH level and P level on the day of HCG injection in MS group were higher than that in SP group（P0.05）.The E2 level,endometrial thickness and number of oocytes on the day of HCG injection in PS group were more than that of the MS group,but the difference is not significant（P0.05）.The MⅡ egg cleavage rate,clinical pregnancy rate of mini-stimulation protocol group were lower than that of the short program group.The implantation rate of MS group was higher than that of SP group,the difference is not significant（P0.05）.Conclusions The mini-stumilation protocol is an ideal program for patients with poor ovarian response.