GnRH-a短方案和GnRH-ant两种促排卵方案对IVF-ET妊娠结局的影响

Effects of short protocol with GnRH-a and GnRH-ant on pregnancy outcome in vitro fertilization

目的比较促性腺素释放激素激动剂(gonadotropin releasing hormone anoloug,GnRH-a)短方案和GnRH拮抗剂(GnRH antagonist,GnRH-ant)两种促排卵方案对试管婴儿(in vitro fertilization,IVF)妊娠结局的影响,探讨更合理的促排卵方案。方法回顾性分析2009年1月-2011年6月在北京妇产医院生殖中心进行IVF助孕的不孕患者,病例纳入标准:年龄20-39岁,体重指数(Body Mass Index,BMI)18-25,不孕年限<10年,HCG注射日内膜厚度8-15cm,应用GnRH-a短方案进行促排卵的132例,GnRH-ant方案的145例,比较两种促排方案对妊娠结局的影响。结果 GnRH-a短方案组和GnRH-ant组平均年龄分别为32.98±3.55、33.06±3.38岁,平均BMI分别为21.08±1.79、21.30±1.84,平均不孕年限分别为3.79±2.36、3.89±2.02年,HCG注射日平均内膜厚度分别为10.27±1.55、10.27±1.70cm,影响妊娠的主要因素差异均无统计学差异(P>0.05)。GnRH-a短方案组临床妊娠率为34.85%,GnRH-ant组临床妊娠率为33.1%,两组间获卵数、成熟卵、受精卵数及临床妊娠率均未见统计学差异(P>0.05)。结论应用GnRH-a短方案和GnRH-ant两种促排方案妊娠结局无统计学差异,GnRH-ant可和GnRH-a短方案一起作为卵巢储备功能不良的病人优选促排方案。

Objective： To compare the pregnancy outcome of short protocol with GnRH - a and GnRH - ant in patients undergoing in vitro fertilization -embryo transfer （IVF -ET）. Methods： The clinical data of patients undergoing IVF in Beijing Obstetrics and Gynecology Hospital from January 2009 to June 2011 were analyzed retrospectively. Standard： age： 20 -39, BMI： 18 -25, years of infertility： 〈 10, endometrial thickness on the day of injection of HCG： 8 - 15cm. Short Protocol with GnRH - a cases were 132, GnRH - ant 145. The outcome of IVF - ET was compared. Results ： There were no statistical difference in ages, BMI, years of infertility and endometrial of main elements that effect implantation of embryos （P 〉0. 05）. Pregnancy rate of Short Protocol with GnRH - a was 34. 85% and GnRH- ant 33. 1%, there were no statistical differences in the number of occytes retrieved, mature occytes, fertilizable occytes and pregnancy rate （P 〉 0. 05）. Conclusion： There was no statistical difference in the pregnancy outcome of Short Protocol with GnRH - a and GnRH -ant, GnRH -ant could be the preferred way of COH as GnRH -a for patients with diminished ovarian reserve.