三种丙氨瑞林给药方案在体外受精-胚胎移植中的效果比较

Comparison on the effect of three Alarelin dosing regimens in vitro fertilization-embryo transfer

目的:比较三种丙氨瑞林给药方案在体外受精-胚胎移植(IVF-ET)中的应用效果。方法:回顾性分析246例首次IVF-ET助孕患者的病历资料,按不同的丙氨瑞林给药方案分为三组,A组:自上次月经周期黄体中期开始,每日肌注丙氨瑞林0.3mg,14d后开始使用Gn,丙氨瑞林继续每日肌注0.3mg至HCG日。B组:自上次月经黄体中期开始,每日肌注丙氨瑞林0.3mg,14d后开始使用Gn,丙氨瑞林减量为每日肌注0.15mg至HCG日。C组:自上次月经周期黄体中期开始,隔日肌注丙氨瑞林0.3mg,14天后开始使用Gn,丙氨瑞林继续隔日肌注0.3mg至HCG日。比较三组间内源性LH峰发生率、重度OHSS发生率、丙氨瑞林使用量、Gn用药时间,Gn总量,HCG注射日E2、LH、P值、平均获卵数、MII卵率、2pn受精率、平均优质胚胎数、临床妊娠率、流产率、宫外孕率。结果:三组资料均未出现早发LH峰或提前排卵情况,均未出现重度卵巢过度刺激征。三组间丙氨瑞林使用量、Gn用药时间,Gn总量,HCG注射日E2、LH、P值、平均获卵数、MII卵率、2pn受精率、平均优质胚胎数、临床妊娠率、流产率、宫外孕率均无显著性差异,但A组丙氨瑞林使用量高于其他两组,A组临床妊娠率有高于其他两组的趋势。结论:丙氨瑞林应用于体外受精-胚胎移植促排卵治疗安全有效。三种用药方案的临床效果无统计学差异,A组方案的临床妊娠率较其他两组有升高趋势,

Objectives： To compare the effects of three Marelin dosing regimens in vitro fertilization - embryo transfer. Methods： A retrospective analysis was made on the medical records of 246 cases of assisted reproduction patients with first IVF - ET. They were divided into three groups according to the different Alarelin treatment regimen. Group A started using Marelin 0. 3Mg. daily since the last mid -luteal phase of their menstrual cycles. Gn began to be used 14 days later. The use of Alarelin 0. 3Mg daily continued till the day of HCG ; group B started using Marelin O. 3Mg daily since the last mid - luteal phase of their menstrual cycles. After 14 days, Gn started to be used. The use of Alarelin 0.15Mg daily continued till the day of HCG; Group C started using Marelin 0.3Mg daily since the last mid - luteal phase of their menstrual cycles, Gn started to he used after 14 days and the continued use of Alarelin 0.3Mg every other day lasted till the day of HCG. The three groups were compared in the incidence of premature LH surge, incidence of severe OHSS, average Alarelin dosages, Gn use days, Gn dosages, Number of oo- eytes obtained, rate of oocytes fertilized , Number of high quality embryo, the rate of clinical pregnancy and the rate of miscar- riage . Results ： All the three groups showed no sign of premature LH surge, early ovulation, and ovarian hyperstimulation. No significant differences were observed in Alarelin dosages, Gn use days, Gn dosages, the levels of serum E2 , LH, P measured oil the day of hCG administration, the number of oocytes, rate of metaphase II oocytes, rate of oocytes fertilized （2PN） , the average number of high quality embryo, the rate of clinical pregnancy, the rate of miscarriage and rate of exfetation among these groups.But, the amount of Alarelin dosages in group A was higher than that in the other two groups. Group A tended to have higher preg- nancy rate than the other two groups. Conclusion： Alarelin was safe and effective when applied in vitro fertilization - embryo transfer, There were no statistically significant differences in the three Alarelin dosing regimens. The rate of clinical pregnancy of group A is comparatively higher than the other two groups.