多囊卵巢综合征患者体外受精-胚胎移植不同降调节方案的比较

Comparison of different down-regulation protocols of in vitro fertilization-embryo transfer for treatment of patients with polycystic ovarian syndrome

目的探讨长方案与短方案对于多囊卵巢综合征患者(PCOS)的治疗结局。方法收集2008年至2010年在我中心行体外受精-胚胎移植/卵胞浆内单精子注射(IVF/ICSI)治疗的PCOS患者共135例临床资料,按不同的降调节方案,分为长方案A组和短方案B组,回顾性分析两组的治疗结局。比较两组间患者年龄、不育年限、体重指数、基础卵泡刺激素(FSH)、基础黄体生成素(LH),促性腺激素(Gn)用药总量、人绒毛膜促性腺激素(hCG)日雌二醇(E_2)值、获卵数、受精率、优质胚胎率、种植率、临床妊娠率、流产率、活产率和卵巢过度刺激综合征(OHSS)发生率。结果 A组的Gn用量、获卵数、OHSS的发生率显著高于B组,差异有统计学意义(P<0.05);两组间hCG日E_2值、受精率、优质胚胎率、种植率、临床妊娠率、流产率,活产率,无统计学意义(P>0.05)。结论短方案较长方案Gn用量少,缩短治疗的时间,且OHSS发生率低,减轻了患者经济和精神负担,更适合PCOS患者。

Objective： To investigate the outcomes between long and short protocols for treatment of patients with polycystic ovarian syndrome（PCOS）. Methods. A total of 135 infertile women with PCOS undergoing IVF/ICSI in our center were enrolled in this retrospective study. According to the different down-regulation protocols, the patients were divided into two groups, the long protocol group （group A） and the short protocol group （group B）. The patients＇ age, infertile years, body mass index, baseline FSH ~ LH, baseline T, gonadotropin （Gn） used, serum estradiol concentration on the day of hCG injection, retrieved oocytes, fertilization rate, high quality embryo rate, clinical pregnancy rate, abortion rate, live birth rate, incidence of ovarian hyperstimulation syndrome （OHSS） were compared between the two groups. Results： The Gn used, retrieved oocytes, incidence of OHSS in group A were significantly higher than those in group B （P 〈 0. 05）. There were no statistically significant differences in serum estradiol concentration on the day of hCG injection, retrieved oocytes, fertilization rate, high quality embryo rate, clinical pregnancy rate, abortion rate and live birth rate between the two groups （P〉0.05）. Conclusions. Compared to the long protocol, the short protocol had advantages of shorter time, fewer Gn used, and lower OHSS incidence. The economic and psychological burdens of patients were milder. So it was more acceptable for PCOS.