不同小剂量长效达菲林在体外受精-胚胎移植中的临床应用效果分析

Clinical effects of different low-dose depot Diphereline in in vitro fertilization and embryo transfer

目的 探讨不同小剂量长效促性腺激素释放激素激动剂（GnRH-α,达菲林）在体外受精-胚胎移植（IVF-ET）中的临床效果及对IVF-ET结局的影响.方法 回顾性分析170个IVF治疗周期,根据黄体中期使用的GnRH-α剂量不同分为3组：A组达菲林用量1.0 mg （43例）,B组达菲林用量1.1～1.2 mg （74例）,C组达菲林用量1.3～1.5 mg （53例）,比较临床效果和IVF-ET治疗结局.结果 三组降调节时间、Gn用药天数、受精率、优胚率、妊娠率、种植率、早期流产率、卵巢过度刺激综合征（OHSS）发生率差异均无统计学意义（P＞0.05）,Gn用量C组高于A组,获卵数A组最低,差异有统计学意义（P＜0.05）.结论 在长方案中应用1.0～1.5 mg达菲林可获得相似的妊娠结局,1.0 mg达菲林可达到有效的降调节效果且减少Gn用量,是更好的选择.

Objective To explore the influence and clinical effects of the low-dose depot Diphereline in the long protocol of controlled ovardan stimulation for in vitro fertilization and embryo transfer （IVF-ET）.Methods A retrospective analysis was performed on a total of 170 IVF-ET cycles.According to the doses of GnRH-α used at mid-luteal phase,the patients were divided into three groups：group A （1.0 mg,a total of 43 cycles）,group B （1.1～1.2mg,a total of 74 cycles） and group C （1.3～1.5 mg,a total of 53 cycles）.The clinical effects of controlled ovarian stimulation and IVF-ET outcomes were compared.Results There was no significant difference in the duration of pituitary down-regulation,the days of Gn therapy,fertilization rate and high quality embryo rate.No significant difference was observed in pregnancy rate,implantation rate,early abortion rate and the incidence of ovarian hyperstimulation syndrome among the three groups （P〉0.05）.The dosage of Gn therapy were greater in group C than in group A,and the number of oocytes retrieved in group A were the least among the three groups （P〈0.05）.Conclusion Almost the same pregnancy outcomes can be obtained when using 1.0～1.5 mg of depot Diphereline in the long protocol of controlled ovariaan stimulation.Successful pituitary down-regulation can be obtained using 1.0 mg of depot Diphereline,with low dosage of Gn therapy.