达必佳短效长方案延长降调时间对IVF周期结局影响的研究

Effect of extending regulation time of triptorelin on the outcome of in vitro fertilization cycle

目的:探讨达必佳短效长方案垂体降调节不同时间对体外受精-胚胎移植(IVF-ET)结局的影响。方法:2013年10月至2015年9月在枣庄市妇幼保健医院生殖医学中心接受体外受精-胚胎移植(IVF-ET)患者769例,选择黄体中期垂体降调节达必佳短效长方案,根据降调节时间不同分为A组219例,降调节14d;B组400例,降调节16d;C组150例,降调节18d。启动日促性腺激素(Gn),起始剂量为150-225IU/d。主要观察3组患者Gn用量、Gn天数、获卵数、卵裂率、优质胚胎率、种植率、胚胎着床率、临床妊娠率、流产率等。结果:随着降调天数的增加,Gn用量减少,获卵数、优胚胎数、种植率及妊娠率增加并有统计学意义。结论:在达必佳短效长方案中适当延长垂体降调节时间,可以减少卵巢刺激时间,减少Gn用量,可以增加有效卵泡的比例,改善卵泡发育的同步性,获得更多的卵泡数、优质胚胎数及更高的临床妊娠率。

Objective： To explore the effect of different regulation time of triptorelin on the outcome of invitro fertilization-embryo transfer（ IVF-ET）. Methods： 769 patientsreceived IVF – ET in our hospital from October 2013 to September 2015 were selected and divided into 3 groups according to different regulationtime,group A of219 cases for 14 d,group B of 400 cases for 16 d andgroup C of 150 cases for 18 d. The initiating dose of the gonadotropin hormone（ Gn） was 150-225 iu/d. The Gn dosage,Gn days,ovulation number,cleavage rate and high quality embryo rate,implantation rate,clinical pregnancy rate and abortion rate of the three groups were observed.Results： With the increase of regulation time,the Gn dosage decreased,the number of eggs obtained,the number of embryos,the implantation rate and the pregnancy rate increased,with statistical significance. Conclusions： Extending regulation time of triptorelin willreduce the time of ovarian stimulation and the Gndosage,increase the proportion of effective follicle and improve the synchronicity of follicular,and get more follicles and high-quality embryo number with higher clinical pregnancy rate.