国产醋酸亮丙瑞林在体外受精-胚胎移植超长方案的应用

Aplication of leuprorelin for ovulation induction in ultra-long protocol of IVF-ET

目的分析体外受精-胚胎移植(IVF-ET)超长方案中国产亮丙瑞林与进口曲谱瑞林的垂体降调节效果及临床结局。方法回顾性分析在本中心行IVF-ET超长方案治疗的患者267例,其中亮丙瑞林组113例,曲谱瑞林组154例。比较两组促性腺激素(Gn)启动日及HCG注射日血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平,以及其他相关临床参数的差异。结果亮丙瑞林组的卵巢过度刺激率明显低于曲谱瑞林组(1.77%vs.10.39%)(P<0.05);两组Gn启动日及HCG注射日FSH、LH、E2、P水平,Gn使用时间、启动用量、总用量,HCG日内膜厚度、获卵数、受精率、卵裂率、优质胚胎率、种植率、临床妊娠率、流产率、异位妊娠率、周期取消率,均无统计学差异(P>0.05)。结论在IVF-ET超长方案促排卵治疗中,国产醋酸亮丙瑞林与进口曲谱瑞林临床效果相似,可以成为垂体降调节药物的一种理想选择。

Objective： To observe the efficacy of leuprorelin on Methods： The clinical data of 267 patients who reproductive center were retrospective analyzed. Among down regulation and clinical outcome of IVF-ET. received ultra-long protocol of IVF-ET in our the patients, 113 received subcutaneous injection of leuprorelin for down regulation and 154 received triptorelin. The data including hormone levels on gonadotropins initiated day and HCG trigger day, doses and duration of gonadotropins used, endometrial thickness on HCG trigger day, number of the oocytes retrieved, fertilization rate, cleavage rate, high-quality embryos rate,implantation rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, incidence of ovarian hyperstimulation,cancelled cycles rate were compared between the two groups. Results： The incidence of ovarian hyperstimulation in the leuprorelin group was obviously lower than that in the triptorelin group（P,0.05）. There were no significant differences in the hormone levels on gonadotropins initiated day and HCG trigger day, doses and duration of gonadotropins used, endometrial thickness on HCG injection day, number of the oocytes retrieved, fertilization rate, cleavage rate, high- quality embryos rate, implantation rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate and cancelled cycles rate between the two groups（P〉0.05）. Conclusions： The clinical efficacy of leuprorelin is similar with triptorelin in ultra-long protocol ovulation induction of IVF-ET. It might be one of ideal medicines for pituitary down regulation.