重组人生长激素超促排卵对卵巢反应不良患者的影响分析

Analysis of effect of recombinant human growth hormone superovulation on patients with poor ovarian response

目的探讨重组人生长激素在进行体外受精-胚胎移植(IVF-ET)超促排卵过程中对卵巢反应不良患者的影响。方法 60例进行体外受精-胚胎移植治疗的卵巢反应不良患者,随机分为实验组和参照组,各30例。两组均给予促性腺激素释放激素-α以及人绝经期促性腺激素(HMG),在此基础上实验组患者给予重组人生长激素,参照组患者未给予重组人生长激素。对两组患者获卵数、减数分裂中期(MⅡ期)卵数、获胚数及优质胚胎数进行比较,同时采用酶联免疫吸附试验测定血清胰岛素样生长因子Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白-3(IGFBP-3)的浓度。结果实验组获卵数、MⅡ期卵数、获胚数及优质胚胎数均略多于参照组,但差异无统计学意义(P>0.05)。实验组降调日、启动日及人绒毛膜促性腺激素(HCG)日的IGF-Ⅰ浓度分别为(282.98±34.75)、(280.40±34.94)、(297.08±27.36)μg/L,均高于参照组的(264.25±34.79)、(262.67±33.34)、(271.38±32.28)μg/L,差异有统计学意义(P<0.05)。实验组患者降调日、启动日、HCG日的血清IGFBP-3浓度均略高于参照组患者,但差异无统计学意义(P>0.05)。结论联合应用重组人生长激素能够有效对卵巢反应不良患者体外受精-胚胎移植的结局进行改善,其临床机制和提升血清浓度以及改善卵子质量有显著相关的联系。

Objective To investigate the effect of recombinant human growth hormone on patients with poor ovarian response during process of superovulation in in vitro fertilization and embryo transfer （IVF-ET）. Methods A total of 60 patients with poor ovarian response treated with in vitro fertilization and embryo transfer were randomly divided into experimental group and control group, with 30 cases in each group. Both groups received gonadotropin releasing hormone-α and human menopausal gonadotropin （HMG）, and the experimental group also received recombinant human growth hormone. The control group received no recombinant human growth hormone. Comparison were made on number of oocytes obtained, number of ovum in the middle stage of meiosis （stage M Ⅱ）, number of embryos obtained and number of high-quality embryos. Serum insulin-like growth factor I （IGF- I ） and lnsuhn-hke growth factor binding protein -3 （IGFBP-3） were measured by enzyme linked immunosorbent assay （ELISA）. Results The experimental group had a little more number of oocytes obtained, stage M Ⅱ ovum and high-quality embryos than the control group, but the difference was not statistically significant （P〉O.05）. The experimental group had concentration of IGF- I at decreased day, start day and human chorionic gonadotropin （HCG） day respectively as （282.98 ± 34.75）, （280.40 ± 34.94） and （297.08± 27.36） μg/L, which were all higher than （264.25 ± 34.79）, （262.67± 33.34） and （271.38 ± 32.28） μg/L in the control group, and their difference was statistically significant （P〈0.05）. The experimental group had a little higher concentration of serum IGFBP-3 at decreased day, start day and HCG day than the control group, but the difference was not statistically significant （P〉0.05）. Conclusion Application of recombinant human growth hormone can effectively improve the outcomes of in vitro fertilization and embryo transfer in patients with poor ovarian response, and its clinical mechanism is significantly related to the promotion of serum concentration and the improvement of ovum quality.