生长激素联合拮抗药用于体外受精助孕高龄患者的临床研究

Clinical trial of growth hormone combined with antagonist regimen for in vitro fertilization in elderly women

目的观察生长激素(GH)联合拮抗药方案用于体外受精(IVF)助孕高龄患者的临床疗效和安全性。方法将120例接受IVF助孕高龄患者随机分为对照组60例和试验组60例。对照组予以拮抗药方案治疗;试验组在对照组治疗的基础上,于排卵后6~7 d予以GH 4.5 U,qd,皮下注射,直至绒毛膜促性腺激素(HCG)注射日。比较2组患者的临床妊娠率、促性腺激素释放激素(Gn)使用天数和总量、取卵数,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的临床妊娠率分别为51.85%和30.91%,Gn使用天数分别为(10.45±1.68)和(11.12±1.67)d,Gn使用总量分别为(2353.01±731.13)和(2669.17±948.28)U,取卵数分别为(7.10±2.59)和(4.93±3.22)个,差异均有统计学意义(均P<0.05)。2组患者的药物不良反应以注射部位疼痛和红肿为主。试验组和对照组的总药物不良反应发生率分别为6.67%和5.00%,差异无统计学意义(P>0.05)。结论生长激素联合拮抗药方案用于IVF助孕高龄患者的临床疗效显著优于单用拮抗药方案,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of growth hormone（ GH） combined with antagonist regimen for in vitro fertilization（ IVF）. Methods A total of 120 elderly women receiving IVF were randomly divided into control and treatment groups with60 cases per group. Control group was treated with antagonistic regimen. Treatment group received subcutaneous injection of once daily4. 5 U GH starting from 6 th or 7 th day after ovulation until the day of injection of human chorionic gonadotropin（ h CG）,on the basis of control group. The clinical pregnancy rate,dose and days of gonadotropin-releasing hormone（ Gn）,number of oocytes retrieved and adverse drug reactions were compared between the groups. Results After treatment,the main indexes in treatment and control groups were compared： clinical pregnancy rates were 51. 85 % and 30. 91 %,the using days of Gn were（ 10. 45 ± 1. 68） and（ 11. 12 ± 1. 67） d,the total dose of Gn were（ 2353. 01 ± 731. 13） and（ 2669. 17 ± 948. 28） U,the number of oocytes retrieved were（ 7. 10 ± 2. 59） and（ 4. 93 ± 3. 22）,the differences were statistically significant（ all P〈 0. 05）. The main adverse drug reactions of two group were pain and redness at the injectionsite. The incidences of adverse drug reactions in the treatment and control groups were 6. 67 % and 5. 00 %,without any significant difference（ P 〉0. 05）. Conclusion GH combined with antagonist regimen in elderly women during IVF has a better clinical efficacy than antagonist regimen alone,without increasing the incidence of adverse drug reactions.