低剂量FSH联合GnRH拮抗剂方案在卵巢低反应中的临床研究

Clinical research of low dose FSH combined with GnRH antagonist in poor ovarian response

目的探讨使用150IU/天的促卵泡刺激素联合GnRH拮抗剂方案在卵巢低反应患者行体外受精-胚胎移植中的应用价值。方法对139周期卵巢低反应患者行体外受精-胚胎移植时使用低剂量促卵泡刺激素联合GnRH拮抗剂方案的临床资料进行回顾性分析。结果起始周期139周期,取卵126周期,移植109周期,周期取消率为21.58%。促卵泡刺激素激素平均使用量为1259.09±282.51IU,平均拮抗剂使用量为0.78±0.26mg。共获卵506个、成熟卵子数为438个、胚胎305个,优质胚胎数184个。平均每取卵周期获卵数4.02±2.51个,胚胎2.46±1.49个,优质胚胎数1.46±1.43个。平均每周期移植胚胎数为1.86±0.67个。临床妊娠45例,每移植周期临床妊娠率为41.28%,着床率为26.60%。≤35岁组的获卵数、妊娠率、着床率较≥40岁组明显增高,有显著性差异。各年龄组中拮抗剂用量、促性腺激素用量、成熟卵子数、胚胎数、优质胚胎数及移植胚胎数均无显著性差异。结论 1.150IU/天低剂量促卵泡刺激素联合GnRH拮抗剂方案是治疗卵巢低反应者的有效治疗方案;2.年龄是影响体外受精胚胎移植结局的重要因素。

Objective： To explore the application worth of the dose 150 IU/day Follicle -stimulating hormone （FSH） combined with Gonadotropin releasing hormone （GnRH） antagonist in patients with poor ovarian response in vitro fertilization and embryo transfer （IVF - ET）. Methods ： A retrospective study of 139 cycles poor ovarian response with IVF - ET in low dose FSH combined with Gn- RH antagonist was analyzed. Results： Total of 139 originate cycles were identified. The number of oocyte retrievals cycles was 126 and embryos transferred cycles was 109. The rate of cancling cycle was 21.58%. Mean FSH administered was 1259.09 ± 282.511U and Mean GnRH antagonist administered was 0. 78± 0. 26mg. The total number of oocyte was 506 and mature oocyte was 438. The number of embryos generated was 305 and good quality embryo was 184. Mean number of oocytes retrieved was 4. 02 ± 2.51. Mean number of embryos generated was 2.46 ± 1.49. Mean number of good quality embryo wasI. 46 ± 1.43. Mean number of embryos transferred was 1.86 ± 0. 67.45 clinical pregnancy were obtained. Clinical pregnancy rates / embryo transferred was 41.28%. Implantation rates was 26. 60%. The number of oocytes retrieved, clinical pregnancy rates, implantation rates was respectively higher in the age group of ≤35 - year - old than that in the age group of≥40 - year - old. No significant difference in FSH used, GnRH antagonist used, number of mature oocyte, number of embryos generated, number of good quality embryo, number of embryos transferred was observed among three groups. Conclusions ： 1. The dose 150 IU/day FSH combined with GnRH antagonist protocol have efficacy in improving treatment outcomes of poor responder patients. 2. Age is important factor affecting the outcome undergoing IVF- ET.