黄体期促排卵在卵巢低反应患者中的应用

Application of luteal phase ovarian stimulation in patients with poor ovarian response

目的探讨体外受精-胚胎移植(IVF-ET)周期中,黄体期促排卵在卵巢低反应(POR)患者中的应用及临床体会。方法回顾性分析POR的227个IVF周期,分析克罗米芬微刺激阶段和后续的黄体期促排卵阶段的一般资料、获卵数、取消率、再获卵率等及冷冻胚胎移植妊娠结局等指标。总结黄体期促排卵应用于POR患者中的临床体会。结果两个阶段间MII卵率、受精率、优质胚胎率均无统计学差异(P>0.05),但黄体期促排卵阶段的平均获卵数明显高于微刺激阶段(P<0.05)。微刺激阶段及黄体期促排卵阶段所获得的冷冻胚胎进行移植后,临床妊娠率为28.8%,胚胎种植率为15%。黄体期促排卵方案的再获卵率64.4%。结论在POR患者中,黄体期促排卵方案周期获卵数及再获卵率高,能降低患者心理压力,获得较满意的临床妊娠结局,提示黄体期促排卵方案对于POR患者是一种值得尝试的促排卵方案。

Objective： To assess the efficacy of luteal phase ovarian stimulation protocol in poor ovarian responders（PORs）undergoing in vitro fertilization. Methods： A retrospective analysis was performed for 227 IVF cycles adopted mild ovarian stimulation （MOS）protocol and sequent luteal phase ovarian stimulation（LPS）protocol. The clinical data including number of retrieved oocytes, number of mature oocytes, abortion rate and pregnant outcome, etc. were analyzed. Results： The mature oocytes rate and fertilization rate were not statistically different between the MOS stage and LPS stage. Meanwhile, the good quality embryo rate was not significantly different between the two stages （P〉0.05）. The frozen embryos obtained from the MOS and LPS stages were implanted. The clinical pregnancy rate and the implantation rate were 28.8% and 15% respectively. The oocytes retrieval rate in LPS stage was 64.4%. The ooeytes retrieval rate was significantly higher in LPS stage than that in MOS stage（P〈0.05）. Conclusions： In poor ovarian responders,the luteal phase ovarian stimulation protocol would increase the oocytes retrieval rate and decrease the patients psychological stress. So the luteal phase ovarian stimulation protocol may be a valid alternative treatment strategy in poor ovarian responders.