黄体期促排卵方案在卵巢低反应患者中的初步研究

A Preliminary Study of Control Ovary Hyperstimulation on Luteal Phase in Patients with Poor Ovarian Response

目的:探索黄体期促排卵方案在卵巢低反应患者中应用的可行性及其初步效果。方法:分析77例接受黄体期促排卵的不孕症患者的卵泡期和黄体期促排卵时血清激素水平及获卵数、胚胎情况和助孕结局。结果:经过卵泡期和黄体期2次取卵,77例均有取卵机会,且获得卵子的患者数和有胚胎冻存的患者数均比仅接受卵泡期取卵的患者数显著增加(P<0.001和P<0.05);卵泡期与黄体期扳机日内分泌水平亦有统计学差异(P<0.001),黄体期促排卵周期的回收卵子数、冷冻胚胎数均显著多于卵泡期(P<0.001);已接受了冻融胚胎移植(FET)的34例患者中20例获得了临床妊娠。结论:在卵巢低反应患者中实施黄体期促排卵取卵是可行的,可以增加获卵数及获得胚胎的机会,从而为提高妊娠率提供可能。

Objective： To explore the application feasibility and preliminary results of the protocol of control ovary hyperstimulation （COH） on the luteal phase for poor ovarian response patients. Methods： Totally 77 infertilepatients with poor ovarian response receiving IVF/ICSI-ET were analyzed retrospectively, they all accepted COH protocol on the luteal phase. The average number of retrieved oocytes, embryos obtained and pregnany outcomeswere analyzed. Results： After oocytes retrieved on the follicular phase and luteal phase seperately, all of 77 patients accepted opportunities of ooeytes retrieve, the number of patients who obtained oocytes was statistically increasedcompared with only retrieved oocytes on the follicular phase （P〈0.001）, the number of patients who obtained embryos that could be freezed was statistically increased compared with only retrieved ovum on the follicular phase（P〈0.05）. The hormone levels on trigger day were significantly different between follicular phase and luteal phase （P〈0.001）. The average number of retrieved oocytes and frozen embryos obtained on luteal phase were significantlyincreased compared with that on follicular phase （P〈0.001）; 34 patients had undergone frozen-thawed embryo transfer （FET）, and 20 patients had been pregnant. Conclusion： Control ovary hyperstimulation on luteal phase inpoor ovarian response is feasible, the opportunity of obtained oocytes and embryo increased, and then the clinical pregnancy outcome may be improved.