GnRH拮抗剂方案对卵巢低反应患者的应用效果

Effect of GnRHant antagonist regimen on patients with ovarian low reaction

目的比较拮抗剂方案与长方案在卵巢低反应妇女体外受精-胚胎移植(IVF-ET)助孕中的应用效果。方法回顾性分析卵巢低反应患者在实施IVF-ET助孕中采用拮抗剂(GnRH-ant)方案212个周期与采用长方案的189个周期的临床资料。比较2组患者使用促性腺激素(Gn)天数、Gn量、成熟卵子率、受精率、优质胚胎率、临床妊娠率、早期流产率等有无差异。结果拮抗剂组患者的Gn时间(7.22±0.85)d和用量(1540±7.56)IU,明显低于长方案组患者;拮抗剂组患者的成熟卵子率(87.14%)、受精率(79.92%)、新鲜移植临床妊娠率(34.48%)高于长方案组,但差异无统计学意义(P>0.05);拮抗剂组患者的早期流产率(30%)低于长方案组患者,差异亦无统计学意义(P>0.05)。结论对于卵巢低反应的患者选择拮抗剂方案可以有效地降低Gn使用天数和用量,可以获得与采用长方案IVF-ET助孕相似的临床妊娠结局。

Objective To study the application effect of long - term program and antagonist program in in - vitro fertilization （IVF） assisted pregnancy for poor ovarian response. Methods Retrospectively analyzed the clinical datum of 401 poor ovarian response women who received IVF assisted reproductive therapy. They were divided into two groups according to the treatment regimen, including the long -term program group （ 189 cases） and the antagonist group （212 cases）. Embryology index of two groups of patients including the amount of Gn duration of oocytes retrieved （7.22 -0.85） were significantly different （P 〈0.05）. Gn used and endometrial thick- ness were compared, as well as the outcome indexes （ amount of oocytes,pregnancy rate, ectopic pregnancy rate, abortion rate and other related indicators to cancel the cycle）. Results At the end of treatment, the use of gonadotropin and the days of gonadotropin used in the antagonist regimen group were significantly shorter than that in the long -term regimen group, the differences were statistically significant （P 〈 0. 05）. There was no significant difference between the two groups in terms of the number of oocytes retrieved and the fertilization rate （ P 〉 0.05 ）. The incidence of ectopic pregnancy and miscarriage and cycle cancelling in long - term regimen grotip was significantly higher than that in antagonist regimen group （P 〈 0. 05 ）. Conclusions In the treatment of IVF assisted ovulation in poor ovarian response, the use of antagonists make to improve promote pregnancy rate and decrease abortion rate,at the same time it can lighten the financial burden.