重组人黄体生成素在体外受精-胚胎移植高龄患者促排卵中的应用

Use of Recombinant Human Luteinizing Hormone for Ovulation Stimulation in in Vitro Fertilization-Embryo Transfer in Patient with Advanced Age

目的:评价重组人黄体生成素(r-hLH)在高龄患者促排卵中的应用价值以及对临床结局的影响。方法:选择协和医院生殖中心进行试管婴儿治疗,长方案降调节,年龄≥35岁,卵泡刺激素促排卵第7天,血清LH水平低于2U/L的患者146例。根据是否使用r-hLH进行分组:A组78例给予r-hLH治疗,B组68例未给予r-hLH治疗。比较两组患者的血清LH水平变化、平均促性腺激素(Gn)使用量、获卵数、双原核胚胎数、优质胚胎率、着床率及临床妊娠率。结果:两组患者血清LH变化情况、平均Gn用量、获卵数、优质胚胎率差异无统计学意义(P>0.05);A组的平均双原核胚胎数、着床率及临床妊娠率均显著高于B组(P<0.05)。结论:对于卵泡刺激素促排卵第7天血清LH<2U/L的高龄患者,补充r-hLH可以获得较高的双原核胚胎数、着床率及临床妊娠率。

Objective：To evaluate the effects of recombinant human luteinizing hormone on the fertilityresults of older patients, and the impact on pregnancy outcomes. Methods：A retrospective study was carried out on 146 patients, who first received IVF-ET, long protocol, age≥35 years old, and LH levels less than 2 U/L on d 7, from July 2009 to June 2011 in medical reproductive center of Union Hospital. According to the addition r-hLH or not, total 146 patients were divided into two groups. 78 patiens in group A added r-hLH during COS, while 68 patiens never used r-hLH （~group B）. The LH level, the average amount of Gn, thenumber of oocytes, two-pronuclear embryos, high-quality embryo rate, implantation rate and clinical preg- nancy rate in the two groups were compared. Results.No significant difference were observed for LH level, the average amount of Gn, the number of oocytes, high-quality embryo rate in the two groups（ P 〉 0. 05）. However, for two-pronuclear embryos, implantation rate and clinical pregnancy rate, group A was significant- ly higher than group B（ P〈0. 05）. Conclusions; For those elderly patient and LH level were lower than 2 U/ L on d 7 during COS, the addition of r-hLH may secure more double pronuclear embryos, higher implanta- tion rate and clinical oreanancv rate.