卵巢储备正常者COH不同阶段添加高纯度人绝经期促性腺激素对IVF-ET结局的影响

Effects of highly purified human menopausal gonadotrophin(HP-hMG) supplementation on IVF-ET outcomes in patients with normal ovarian reserve during different periods of controlled ovarian hyperstimulation

目的：探讨卵巢储备正常者在促排卵不同阶段添加高纯度人绝经期促性腺激素（highly purified human menopausal gonadotrophin，HP-hMO）对体外受精．胚胎移植（WF-ET）结局的影响。方法：收集接受IVF或单精子胞质内显微注射技术（ICSll治疗的25～35岁卵巢储备功能正常的患者（n=153），根据是否添加HP-hMG及添加时机分为A组（未添加HP—hMG），B组（Gn第1日添加HP—hMG）和C组（Gn第6～8日添加HP．hMG），分析三组妊娠结局。结果：A组hCG注射日LH、E2水平低于B组及C组（P〈0．05），A组hCG注射目P水平高于B组及C组（P〈0．05），获卵数及MII卵子数A组及C组高于B组（P〈0．05），优质胚胎率B组高于A组及C组（P〈0．05），累积妊娠率，C组（85％）高于A组（59．3％）及B组（67．6％），差异有统计学意义（P〈0．05），3组受精率、成熟卵率、种植率差异无统计学意义（P〈0．05）。结论：卵巢储备功能正常者在采用标准长方案促排卵时，中晚期添加HP．hMG可改善累积妊娠结局；卵泡发育不同阶段添加HP—hMG，可能适用于不同的人群。

Objective： To explore the effects of highly purified human menopausal gonadotrophin （HP- hMG） supplementation on in vitro fertilization-embryo transfer （IVF-ET） outcomes in patients with normal ovarian reserve during different periods of controlled ovarian hyperstimulation （COH）. Methods： The patients （n=153） with normal ovarian reserve who accepted IVF or a maceral intracytoplasmic sperm inject/on （ICSI） technology treatment were collected. According to whether supplement HP-hMG and supplementation time, the patients were divided into three groups, group A： did not supplement HP-hMG, group B： supplement HP-hMG on day 1 of Gonadotropin （Gn） therapy, group C： supplement HP-hMG on day 6-8 of Gn therapy. The clinical outcomes were compared among the three groups. Results： There were significant differences in serum LH, E2 and P levels on the day ofhCG administration among groups A, B and C （P〈0.05）. The number of oocytes retrieved and mature oocytes was significantly higher in groups A and C compared with group B （P〈0.05）. The high-quality embryo rate was significantly higher in group B compared with groups A and C （P〈0.05）, the cumulative clinical pregnancy rate in group C was higher than that in groups A and B, which showed a significant difference between groups C and A （P〈0.05）, there were no significant differences in the rates of fertilization, mature oocyte and implantation among the three groups （P〉0.05）. Conclusion： Patients with normal ovarian reserve, when using standard long methods for stimulating ovulation, supplementation of HP-hMG in the middle and late follicle phases can improve pregnancy outcome. Different periods of COH of supplementing HP-hMG may apply to different patients.