两种微刺激方法在IVF卵巢低反应患者中的应用

Application of two kinds of mild-stimulation methods in IVF of ovarian poor response patients

目的探讨两种微刺激方法在体外受精胚胎移植（IVF）卵巢低反应患者中助孕结局的比较。方法回顾性分析进行IVF／卵泡浆内单精子注射（ICSI）助孕的卵巢低反应患者共60个周期，根据用药情况分为两组：来曲唑组：共30个周期；克罗米芬组：共30个周期。分别比较两组患者的一般情况、促性腺激素（Gn）使用天数及总量、IVF相关指标及助孕结局。结果年龄、体质量指数、不孕年限、基础内分泌比较差异均无统计学意义（P〉0．05）；克罗米芬组Gn天数及总量高于来曲唑组（P〈0．05）；平均获卵数、受精率、卵裂率、着床率、临床妊娠率、流产率比较差异均无统计学意义（P〉0．05）。结论两种微刺激促排卵方案对于卵巢储备低下的患者均是有效的促排方案，来曲唑组可以获得与克罗米芬组相似的临床效果，同时减少Gn用量，减轻患者单周期的治疗费用。

Objective To investigate the comparison of assisted reproductive outcome of two kinds of mild-stimulation methods in IVF of ovarian poor response patients. Methods The ovarian poor response patients in IVF/ICSI with a total of 60 cycles was retrospectively analyzed. According to the difference of the ovarian stimuXation, the patients were divided into two groups ： letrozole group ： a total of 30 cycles and clomiphene citrate group ： a total of 30 cycles. The general situation of the patients, Gn dosage and period, indicators associated with IVF lab and IVF outcome in the two groups were compared. Results Age, body mass index, infertility period, the basis of endocrine were not statistically different （P 〉 0.05） in the two groups; Gn doSage and treatment period in clomiphene citrate was higher than that in letrozole group （P 〈 0.05 ） ; Average numbers of oocytes retrieved, fertilization rate, cleavage rate, implantation rate, clinical pregnancy rate, abortion rate had no significant difference in the two groups （P 〉 0.05）. Conclusions Two kinds of mild-stimulation methods for the ovarian poor response patients are both effective. Letrozole could reduce the Gn dosage and single cycle treatment costs and have the same pregnancy rate compared with clomiphene citrate.