低促性腺激素功能减退症2种促排卵方案的比较研究

Comparative study on two kinds of ovarian stimulation protocols for hypogonadotropic hypogonadism

目的：探讨低促性腺激素功能减退症（HH）不孕患者的促排卵方案及临床结局。方法：收集2005年6月-2012年3月在本院进行助孕治疗的12例HH患者的临床资料，回顾性分析2种促排卵方法的效果及临床妊娠结局。采用A方案[人绝经期促性腺激素（hMG）＋人绒毛膜促性腺激素（hCG）]和B方案[重组人促卵泡性素（FSH）＋重组人促黄体激素（rLH）＋hCG32种促排卵方案，待卵泡发育成熟后，指导同房或行人工授精助孕，后并予黄体支持。结果：12例患者共进行了34周期的促排卵治疗，10例妊娠，A方案6例妊娠，周期临床妊娠率为26．1％，B方案4例妊娠，周期临床妊娠率为36．4％。B方案的用药天数短于A方案（P〈0．05），而HCG大于16mm卵泡数和HCG子宫内膜厚度2种方案差异无统计学意义（P〉0．05）。结论：应用FSH＋rLH＋hCG的促排卵方案更加有效，促排卵天数更短，且临床妊娠率更高。

Objective： To explore the ovarian stimulation protocol and clinical outcome of infertile patients with hypogonadotropic hypogonadism （HH） . Methods： The clinical data of 12 HH patients treated with assisted reproduction in the hospital from June 2005 to March 2012 were collected, the effects and clinical pregnancy outcomes of two kinds of ovarian stimulation protocols （protocol A： hMG combined with hCG; protocol B ： FSH ＋ rLH ＋ hCG） were analyzed retrospectively ; after maturity of follicular development, assisted reproduction was performed, then luteal support was conducted. Results： A total of 34 treatment cycles of ovarian stimulation treatment were conducted on 12 HH patients. Ten clinical pregnancies were achieved, including six clinical pregnancies after protocol A and four clinical pregnancies after protocol B, the cycle clinical pregnancy rates of protocol A and protocol B were 26. 1% and 36.4%, respectively; the medication time of protocol B was statistically significantly shorter than that of protocol A （P 〈 0.05）, but there was no statistically significant difference in the number of follicles whose diameter was more than 16 mm and endometrial thickness on the day of hCG injection between the two protocols （ P 〉 0.05 ） . Conclusion： Ovarian stimulation protocol with FSH ＋ rLH ＋ hCG is more effective, the medication time is more shorter, and the clinical pregnancy rate is more higher.