重组人生长激素在卵巢反应正常者体外受精-胚胎移植中的应用价值

Trial of Recombinant Human Growth Hormone in Women with Normal Ovarian Response Undergoing In Vitro Fertilization and Embryo Transfer

目的:探讨重组人生长激素(recombinant human growth hormone,rh GH)对行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的卵巢反应正常患者的疗效。方法:选择2014年1月—2016年12月在宁夏医科大学总医院生殖中心行IVF-ET的卵巢反应正常患者180例。其中添加rh GH治疗者为研究组(91例),未添加rh GH治疗者为对照组(89例)。比较2组患者基本情况及IVF-ET结局。结果:2组不孕时间、促性腺激素用量、人绒毛膜促性腺激素(h CG)日A型内膜比例和移植胚胎数比较,差异无统计学意义(P>0.05)。但研究组年龄、体质量指数(BMI)、h CG日内膜厚度、h CG日雌二醇(E2)水平、优质胚胎数高于对照组,基础FSH水平、获卵数低于对照组,差异有统计学意义(均P<0.05)。2组种植率、临床妊娠率比较,研究组有增高趋势,但差异无统计学意义(均P>0.05)。结论:IVF-ET周期卵巢反应正常患者添加rh GH可促进卵子成熟、胚胎和子宫内膜发育,改善子宫内膜对胚胎的容受性,但并不能改善卵巢反应正常患者的临床妊娠结局。

bObjective：To investigate the effect of recombinant human growth hormone（rh GH） on the clinical outcomes of those patients with normal ovarian response undergoing in vitro fertilization and embryo transfer（IVF-ET）. Methods： A total of 180 patients with normal ovarian response undergoing IVF-ET in our hospital, from January 2014 to December 2016, were divided into two groups. The study group（n=91） received the routine long-term protocol of controlled ovarian hyperstimulation（COH） and rh GH treatment. The control group（n=89） only received the routine long-term protocol of COH. The basic characteristics and pregnancy outcomes of two groups were compared. Results：There were no significant differences in the duration of infertility,gonadotropin dosage, the ratio of type A endometrium and the number of transplanted embryos between the two groups（all P〈0.05）. The age, BMI, endometrial thickness and the level of estrogen on h CG day and the number of embryo with high quality in the study group were significantly higher than those in the control group（P〈0.05）.Compared with the control group, the study group had a limited increase in the implanting rate and clinical pregnancy rate（but P〈0.05）. Conclusions： In those patients with normal ovarian response undergoing IVF-ET,rh GH can promote the egg maturation, embryo and endometrial development, and improve the endometrial tolerance. However, rh GH can not improve the clinical pregnancy outcome of the patients with normal ovarian response.