小剂量hCG联合hMG在低促性腺激素性性腺功能减退症中促排卵的应用

Application of Low-dose hCG Combined with h MG in Ovulation Induction of Hypogonadotropic Hypogonadism

目的：分析小剂量人绒毛膜促性腺激素（h CG）联合人绝经期促性腺激素（h MG）对低促性腺激素性性腺功能减退症（hypogonadotropic hypogonadism,HH）患者促排卵的作用。方法：11例HH者（研究组）于月经第5天开始应用小剂量h CG（100-200 IU/d）联合h MG（150 IU/d）促排卵23个周期。5例HH者（对照组）于月经第5天开始仅应用h MG（150 IU/d）促排卵9周期。对2组HH患者周期应用h MG总剂量、连续刺激时间、诱发排卵日获得平均直径≥18 mm卵泡数、子宫内膜厚度、周期妊娠率进行比较。结果：12组年龄、体质量指数（BMI）、诱发排卵日获得平均直径≥18 mm卵泡数、子宫内膜厚度和周期妊娠率比较差异均无统计学意义（均P〉0.05）。2研究组和对照组促排卵周期应用h MG总剂量分别为（1 829.35±625.35）IU和（2 408.33±263.69）IU,差异有统计学意义（P〈0.05）。3研究组和对照组促排卵连续刺激时间分别为（15.04±2.94）d和（22.89±1.96）d,差异有统计学意义（P〈0.001）。结论：小剂量h CG联合h MG对HH患者促排卵,在维持高周期妊娠率的前提下,可减少h MG用量和缩短促排卵连续刺激时间。

Objective： To explore the application of the low-dose human chorionic gonadotropin （hCG） combined with human menopausal gonadotropin （hMG） in ovulation induction for those patients with hypogonadotropic hypogonadism （HH）. Methods： 11 cases of HH （23 cycles total） received the low-dose hCG （100-200 IU/d） combined with hMG （150 IU/d） for ovulation induction from the fifth day of cycle, as the study group. 5 cases of HH （9 cycles total）, as the control group, received only hMG（150 IU/d） for ovulation induction. Total dose of hMG,ovulation stimulate days,the number of oocyte with mean diameter 〉118 mm, the endometrium thickness on the day of induced ovulation and the pregnancy rate of induction cycle were compared. Results： ① There were not significant differences in age,BMI,the number of oocyte with mean diameter ≥18 mm, the endometrium thickness on the day of induced ovulation and the pregnancy rate of induction cycle between 2 groups （P〉0.05）. ②Total dose of hMG in induction cycle in the study group was significantly lower than that in the control group[（1 829.35±625.35）IU vs. （2 408.33±263.69 IU）,P〈0.05]. ③The continued days of ovulation induction in the study group were significantly less than those in the control group[（15.04±2.94）d vs. （22.89±1.96）d,P〈0.001]. Conclusions： The low-dose hCG combined with hMG in ovulation induction for patients with HH can decrease the dose of hMG and shorten the days of ovulation induction stimulate, with the high pregnancy rate of induction cycle.