改良超长降调节方案用于体外受精-胚胎移植卵巢低反应患者的临床研究

The clinical study of modified prolonged down-regulation protocol used in poor ovarian responders undergoing IVF-ET

目的探讨改良超长降调节方案在既往体外受精-胚胎移植失败的卵巢低反应患者中的应用效果。方法回顾性分析本中心58例连续两周期行体外受精-胚胎移植术的卵巢低反应患者,其中第一周期采用拮抗剂方案,第二周期采用改良超长方案。自身对照比较两组临床及实验室结果。结果第二周期获得了38.2%的临床妊娠率,两组Gn启动剂量、HCG日E2、LH及P值、HCG日子宫内膜厚度、获卵数、移植胚胎数比较无统计学差异(P>0.05),可移植胚胎数、冷冻胚胎数第二周期均较第一周期高,但无统计学差异(P>0.05);Gn天数、优质胚胎率、周期取消率第二周期组较第一周期组高,均有统计学差异(P<0.05)。结论对于既往采用拮抗剂方案失败的卵巢低反应患者,再次行体外受精-胚胎移植可尝试采用改良超长降调节方案。

Objective ： To detect the effection of the modified prolonged down - regulation protocol applied in IVF - ET for patients with poor ovarian response. Methods ： Clinical data of 58 patients undergoing IVF - ET with poor ovarian response were analyzed retro-spectively. The first cycle accepted GnRH - antagonist protocol, the second cycle accepted modified prolonged down - regulation proto-col. The clinical and laboratory indexes were compared between the two cycles. Results ： Clinical pregnancy rate of the second cycle a-chieved 38. 2%. Between the two groups, there were no significant differences in the starting dose of Gn; estradiol, progesterone and luteinizing hormone level on HCG day; thickness of endometrium on HCG day ; number of oocytes retrieved and transplanted embryos （ P 〉 0. 05 ）. Number of transferable embryos and freezing embryos were higher in the second cycle than in the first cycle, but there is no significant difference between the two groups （ P 〉 0. 05 ）. The days of stimulation were longer in the second cycle than in the first cycle with significant difference （ P 〈 0.05 ）, the rate of high quality embryo and cycle cancellation were higher in the second cycle than in the first cycle with significant difference （P 〈 0. 05 ）. Conclusion ： Modified prolonged down - regulation protocol is an effec-tively protocol for poor ovarian responders undergoing a failured GnRH - antagonist protocol before,