不同促排卵方案在卵巢低反应助孕患者中的应用

Application of different stimulate ovulation in patients with ovarian low reaction assisted reproduction

目的探讨不同促排卵方案在体外受精-胚胎移植的低反应患者中的应用价值。方法对广西医科大学第三附属医院生殖中心2011年1月～2012年12月250例351个周期的卵巢低反应患者的临床资料进行回顾性分析,根据不同的促排卵方案分组:微量长方案组90个周期(A组)、拮抗剂方案组85个周期(B组)、超短方案组94个周期(C组)、微刺激方案组82个周期(D组),比较分析各组的促排卵结局。结果各组间的临床妊娠率、获卵数、成熟卵率、受精率、卵裂率、优胚率、周期取消率差异无统计学意义(P>0.05),D组临床妊娠率略高于其他3组;HCG日子宫内膜厚度、P值、LH值差异无统计学意义(P>0.05);D组的促性腺激素(Gn)使用天数及Gn用量明显少于其他3组,差异有统计学意义(P<0.05)。结论对于卵巢低反应患者,微刺激方案为较好的治疗选择。

Objective To explore the clinical value of different ovulation induction in the poor responders during IVF- ET. Methods A total of 250 patients in Reproductive Medical Center of the Third Affiliated Hospital of Guangxi Medical University with poor response were treated for 351 cycles,which were divided into four groups according to different ovulation induction methods：GnRH-a mini dose long protocol group which includes 90 cycles （group A）, an- tagonist protocol group which includes 85 cycles （group B）, short protocol group which includes 94 cycles （group C）, minimal stimulation （group D）. The changes of related indexes were evaluated. Results No significant different was found among the four groups in the clinical pregnancy rate, number of oocytes retrieved,rate of mature eggs, fertiliza- tion rate, cleavage rate,excellent embryo rate and cycle cancellation rate （P 〉 0.05）. The pregnancy rate of group D was a little higher than that of the other three groups. HCG endometrial thickness, P value, LH value difference was not statistically significant （P 〉 0.05）. The days and total amount of Gn used in group D was much lower than that in the other three groups,the difference was statistically significant （P 〈 0.05）. Conclusion The minimal stimulation protocol is an effective choice for poor responders.