来曲唑微刺激方案和短方案对卵巢低反应助孕的临床研究

The Clinical Research of Application about Short Programs and Mini-stimulation Protocols of Letrozole in the Assisted Reproduction Patient of Poor Ovarian Response

目的:探讨卵巢低反应助孕患者在进行体外受精/卵细胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗中来曲唑(LE)微刺激方案和短方案的应用。方法:回顾性分析进行IVF/IC-SI-ET治疗的卵巢低反应患者共206个周期。按治疗方案分短方案组(97周期)和微刺激组(109周期),分别比较两组患者的一般情况、促排卵情况及妊娠结局等。结果:短方案组的促性腺激素(Gn)用量、Gn刺激天数、HCG注射日雌激素(E2)值、≥16mm卵泡数等均高于微刺激组,差异有统计学意义(P<0.05)。而两组成熟率、正常受精率、卵裂率、周期取消率、生化妊娠率及临床妊娠率比较,差异无统计学意义(P>0.05),但微刺激组的优质胚胎率显著高于短方案组(P<0.01)。结论:来曲唑微刺激方案是卵巢反应低下患者较理想的促排卵方案。

Objective：To explore the effect of short programs and mini-stimulation protocols of letrozole on patients with poor ovarian response in vitro fertilization and embryo transfer （IVF-ET）. Methods：206 clinical cases undergoing IVF-ET were analyzed retrospectively. According to the different administration,they were divided into two groups：109 cycles treated with letrozole plus HMG （mini-stimulation group）and 97 cycles treated with GnRH-a plus Gn （short-stimulation group）. Compare the general condition, promoting ovulation rate and the pregnant outcome in each group. Results： There was significant differences between the short-stimulation group and the mini-stimulation group in the duration and the total dose of gonadotropin,Ser- um E2 levels on the day of HCG injection and the number of follicles which was ≥16 mm （ P〈0. 05）. And there was no significant difference between the two groups in maturation rate ,fertilization rate, cleavage rate,circle canceling rate and clinical pregnancy rate between the two groups （P 〉 0. 05）, while the good-quality embry rate was significantly increased in the mini-stimulation group （ P 〈 0. 01 ）. Conclusions. Mini-stimula- tion protocol of letrozole is an preferable option for the poor ovarian response infertile patients.