不同促排卵方案对子宫内膜异位症患者体外受精-胚胎移植妊娠结局的影响

Effect of different down-regulation protocols on the outcome of in vitro fertilization-embryotransfer in patients with endometriosis

目的：探讨不同促排卵方案对子宫内膜异位症（endometriosis，EMs）患者体外受精-胚胎移植（in vitro fertilizationembryotransfer，IVF—ET）妊娠结局的影响。方法：回顾性分析郑州大学第三附属医院生殖中心2010年1月至2012年12月因EMs行IVF—ET共108个周期的患者临床资料，根据促排方案不同，分为长方案组（33个周期）和超长方案组（75个周期），比较2组患者助孕结局。结果：2组患者年龄、不孕年限及基础卵泡刺激素（folliclestimulation homone，FSH）、基础黄体生成素（1uteinizing hormone，LH）、基础雌二醇（estradion，E2）比较差异均无统计学意义（P〉0．05）；超长方案组患者促性腺激素（gonadotropin，Gn）总量、Gn总天数均高于长方案组，但获卵数、卵裂数、可利用胚胎数和优质胚胎数均低于长方案组，差异具有统计学意义（P〈0．05）；超长方案组的临床妊娠率和胚胎植入率均高于长方案组，差异具有统计学意义（P〈0．05）。结论：Ⅲ～Ⅳ期EMs患者使用超长方案促排卵可以提高IVF—ET的临床妊娠率及胚胎植入率。

Objective：To investigate the effect of different down-regulation protocols on the outcome of in vitro fertilization-embryotransfer in patients with endometriosis. Methods：Clinical data of 108 patients with endometriosis who underwent in vitro fertilizationembryo transfer in the reproductive center of the Third Affiliated Hospital of Zhengzhou University from January 2010 to December 2012 were analyzed. According to the different down-regulation protocols,patients were divided into two groups： prolonged therapy group （n=33） and super prolonged therapy group （n=75）. Outcome of assisted reproduction between the two groups was analyzed. Results：There was no obvious difference in patients＇ age, infertility duration, basic of follicle-stimulation hornone, luteinizing hormone and estradion levels（P〉0.05）. Total duration and dosage of gonadotropin were obvious higher in super prolonged therapy than in prolonged therapy group,but the number of oocytes and cleavage, number of transferable embryo and number of high quality embryo were fewer in super prolonged therapy than in prolonged therapy group （P〈0.05）. Clinical pregnancy rate and embryo implantantion rate were higher in super prolonged therapy than in prolonged therapy group（P〈0.05）. Conclusions：Use of super prolonged protocol regulation can improve embryo implantantion rate and pregnancy rate for patients with endometriosis atⅢ～Ⅳ stage.