不同GnRH-a制剂的长方案中卵巢刺激后E_2水平的动态变化被引量：2

Dynamics of estradiol production in different GnRH agonist down regulation long protocols

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摘要目的对比分析短效和长效GnRH-a制剂的长方案中卵巢刺激后E2水平的动态变化,为临床促排卵过程中药物剂量的调整提供依据。方法回顾性分析2014年1月1日~2014年9月30日在本院生殖医学中心使用GnRH-a长方案的IVF/ICSI/胚胎植入前遗传学诊断（PGD）理想周期资料。纳入标准：年龄≤35岁,促排卵过程中没有进行促性腺激素剂量（Gn）的调整,获卵数在11~15个,促排天数在9~13d。按照降调节制剂剂型的不同,将纳入研究的88个周期分为短效长方案组（A组,共34个周期）和减量长效长方案组（B组,共54个周期）,对比分析两组在启动日、促排第5天、第8天以及HCG日E2水平的变化。结果 A组总促排卵天数显著短于B组[（10.2±1.4）vs.（11.3±1.1）d],Gn使用总剂量也显著低于B组[（1 766.8±524.6）vs.（2 134.9±603.6）U]（P〈0.05）。A组促排第5天E2水平[（1 236.0±646.7）vs.（739.0±482.4）pmol/L]及促排第8天E2水平[（5 043.1±2 611.4）vs.（3 885.1±2 345.7）pmol/L]均显著高于B组（P〈0.05）,HCG日两组E2水平无显著差异,平均每个卵的E2水平无显著差异（P〉0.05）。A组和B组的临床妊娠率分别为68.2%和71.8%,胚胎植入率分别为40.4%和48.8%,差异均无统计学意义（P〉0.05）。结论长方案中GnRH-a制剂的类型影响卵巢刺激后E2水平的动态变化。 Objective：To compare dynamic estradiol production between short-acting and long-acting GnRH agonist（GnRH-a）long protocols,for the adjustment of gonadotropin dosage during ovarian stimulation.Methods：The data of 88IVF/ICSI/PGD cycles in our center from Jan 2014 to Sep 2014 were analyzed retrospectively.The inclusion criteria included the followings：age≤35years old,no gonadotropin（Gn）adjustment during stimulation,number of oocytes from 11 to 15,Gn days from 9to 13.According to different down regulation protocols,88 cycles were divided into two groups：group A with short-acting GnRH-a（n=34）,and group B with long-acting GnRH-a（n=54）.Estradiol levels on starting day,stimulation day 5and 8,HCG day were analyzed.Results：Group A had significantly shorter duration of ovarian stimulation [（10.2±1.4）vs.（11.3±1.1）days]and lower total gonadotropin dosage[（1 766.8±524.6）vs.（2 134.9±603.6）U ]than group B（P〈0.05）.The estradiol levels on day 5 [（1 236.0±646.7）vs.（739.0±482.4）pmol/L]and day8 [（5 043.1±2 611.4）vs.（3 885.1±2 345.7）pmol/L ]of group A were significantly higher than group B（P〈0.05）.No significant difference in estradiol levels on HCG day was found between group A and B（P〉0.05）.There also were no significant differences in clinical pregnancy rates（68.2% vs.71.8%）and implantation rates（40.4% vs.48.8%）between the two groups（P〉0.05）.Conclusions：GnRH-apreparation in long protocol has impacts on the dynamics of estradiol production after ovarian stimulation.

作者高军苗本郁刘新颜王轶子周灿权徐艳文

机构地区中山大学附属第一医院生殖医学中心广东省生殖医学重点实验室

出处《生殖医学杂志》 CAS 2015年第10期824-828,共5页 Journal of Reproductive Medicine

基金广东省生殖医学重点实验室项目(2012A061400003) 广东省科技计划项目(2008A030201028) 公益性行业专项基金(201402004)

关键词促性腺激素释放激素激动剂长方案体外受精-胚胎移植 GnRH agonist Long protocol IVF-ET

分类号 R [医药卫生]

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参考文献8

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