不同方案GnRH-a降调节对轻中度子宫内膜异位症患者体外受精-胚胎移植结局的影响

Effect of Different Dosage forms of Gonadotrophin-Releasing Hormone Agonist on In-Vitro Fertilization-Embryo Transfer in Patients with Mild Endometriosis

目的:探讨不同方案促性腺激素释放激素激动剂(GnRH-a)对轻中度子宫内膜异位症(EMT)患者行体外受精-胚胎移植(IVF-ET)的助孕结局的影响。方法:选择成都市妇女儿童中心医院生殖中心269个IVF助孕周期(175例患者)进行回顾性分析,按GnRH-a的不同方案进行分组:超长方案组75例共102个周期(长效GnRH-a 3.75 mg)、长效长方案组69例共87个周期(长效GnRH-a 1.875 mg)及短效长方案组31例共80个周期(GnRH-a 0.1 mg)。比较3种降调节方案的助孕情况及妊娠结局。结果:超长方案组中Gn用量及Gn天数均多于长效长方案组及短效长方案组,差异有统计学意义(P<0.05)。长效长方案组胚胎种植率、生化妊娠率及临床妊娠率高于超长方案组及短效长方案组,差异有统计学意义(P<0.05),超长方案组与短效方案组相比,差异无统计学意义(P>0.05)。结论:对于接受IVF助孕的轻中度EMT患者采用长效长方案降调节可能更有利于提高EMT不孕患者的临床妊娠率。

Objective：To investigate the effect of different dosage forms of gonadotropin-releasing hormone agonist（GnRH-a） on in vitro fertilization-embryo transfer（IVF-ET） in patients with mild endometriosis. Methods： Totally 269 cycles（175 cases） of IVF-ET were included,which was divided into three groups：pro-long protocols （long acting 3. 75mg group,102 cycles）,long protocols（long acting 1. 875mg group,87 cycles） and short proto- cols（short-acting 0. 1 mg group,80 cycles）. The clinical results were compared among groups. Results：The a- mount of gonadotropin（Gn） were significantly higher in pro-long protocol than the other ones. The implantation rate and clinical pregnancy rate were significantly higher in long acting 1. 875mg group than the other two protocols （P 〈 0. 05）. Conclusions：Long protocol （long acting GnRH-a down-regulation, 1. 875mg） may be more beneficial to improve the implantation rate and clinical pregnancy rate of in vitro fertilization-embryo transfer（IVF-ET） in patients with endometriosis.