摘要
目的：探讨低剂量促性腺激素释放激素激动剂（GnRH-a）改良超长降调节对体外受精/卵胞浆内单精子注射—胚胎移植术（IVF/ICSI-ET）结局的影响。方法 ：选择既往已行IVF/ICSI-ET 1~3周期未孕患者226例,其中A组多囊卵巢综合征（PCOS）患者86例,B组卵巢低反应患者43例,C组单纯输卵管因素或男方因素患者97例,所有患者在前一周期中均为常规长方案促排卵。在本周期中均采用改良超长方案,两次降调节达菲林用量均小于或等于1.25 mg（1/3支）,比较3组患者前、后两个不同促排卵周期超促排卵天数、Gn用量、启动日及h CG日血清激素水平、获卵数、优质胚胎率、临床妊娠率等。结果：3组患者前、后两个周期h CG日E2值及P值、h CG日子宫内膜厚度、获卵数、受精率、优质胚胎率比较差异无统计学意义（P〉0.05）;3组的改良超长周期Gn总剂量C组增加,A、B两组减少,但差异均无统计学意义（P〉0.05）;启动日FSH值、胚胎着床率、临床妊娠率改良超长周期较长方案周期高,Gn天数缩短,差异均有统计学意义（P〈0.05）。结论：低剂量降调节改良超长方案对于大多数患者是一种有效、经济的促排卵方案。
Objective： To explore the effect of low - dose gonadotropin releasing hormone agonist （GnRHa） modified super - long downregulation protocol on in vitro fertilization/intracytoplasmic sperm injection- embryo transfer （IVF/ICSI -ET） outcome. Methods： A total of 226 non -pregnant patients （1 -3 cycles of IVF/ICSI） were selected and divided into group A （86 patients with polycystic ovary syndrome）, group B （43 patients with ovarian poor response） and group C （97 patients with simple tubal or male factors） . All the patients were treated with conventional long protocol to induce ovulation in the last cycle. Modified super - long down - regulation protocol was used in this cycle, the dosages of diphereline used for down - regulation for two times were 1.25 mg or less than 1.25 mg（ 1/3 injection） . The hyperstimnlation days, the dosages of gonadotropin （Gn）, serum hormone levels on the day of start and the day of human chorionic gonadotropin （hCG） injection, the numbers of retrieved oocytes, high quality embryo rates and clinical pregnancy rates of two different ovulation induction cycles in the three groups were compared. Results： There was no statistically significant difference in estradiol and progestin levels on the day of hCG injection, endometrial thickness on the day of hCG injection, the number of retrieved oocytes, fertilization rate and high quality embryo rate between the two ovulation induction cycles in the three groups （ P 〉 0.05 ） ; during modified super - long cycles, the total dosages of Gn increased in group C and decreased in group A and group B, but there was no statistically significant difference （ P 〉 0.05 ） ; follicle - stimulating hormone （FSH） level on the day of start, implantation rate and clinical pregnancy rate during modified super - long cycles were higher than those during conventional long cycles, there were statistically significant differences （P 〈 0.05 ） . Conclusion： Low - dose modified super - long down - regulation protocol is an effective and economical ovulation induction scheme for the majority of patients.
出处
《中国妇幼保健》
CAS
北大核心
2014年第33期5450-5452,共3页
Maternal and Child Health Care of China
