不同年龄卵巢低反应患者应用高孕激素状态下促排卵方案疗效分析

Clinical efficacy of progestin-primed ovarian stimulation protocols in poor ovarian response patients at different age undergoing progestin-primed ovarian stimulation protocol

目的:比较高孕激素状态下促排卵方案在不同年龄组卵巢低反应患者中的应用效果。方法:回顾性分析2016年4月至2016年12月在武汉大学人民医院生殖中心行高孕激素下促排卵方案的卵巢低反应患者,共150周期,按照年龄分为两组(≤35岁组、>35岁组)。比较两组患者的获卵数、2PN受精率、2PN卵裂率、优胚率、可移植胚胎率、未获卵周期率、周期取消率、胚胎种植率、临床妊娠率。结果:两组患者的AFC及基础E_2、b FSH/b LH比较无统计学意义(P>0.05);两组患者Gn用量与天数比较亦无统计学意义(P>0.05);获卵数低龄组明显多于高龄组(P=0.001);虽差异无统计学意义,但低龄组患者2PN受精率、2PN卵裂率、优胚率、可移植胚胎率较高龄组增高,未获卵周期率、周期取消率较高龄组降低。结论:PPOS对于卵巢低反应患者是有效的促排卵方案,低龄患者可以获得更好的治疗结局。

Objectives:To compare the efficacy of progestin-primed ovarian stimulation protocols in poor ovarian response(POR)patients at different age undergoing progestin-primed ovarian stimulation protocol(PPOS).Methods:A retrospective analysis was performed in a total of 150 cycles received PPOS from April 2016 to December 2016.The patients were divided into two groups according to age threshold of 35 years.Number of retrieved oocytes,the 2PN fertilization rate,the 2PN cleavage rate,the rate of high-quality embryo,the rate of utilized embryos,the rate of no available oocytes,the cycle cancellation rate,embryo implantation rate and clinical pregnancy rate were compared.Results:There were no significant difference in general condition and basic hormone levels between the two groups(P>0.05),in addition to infertility years.No significant difference was found between the two groups in the duration and dosage of gonadotropin.Number of retrieved oocytes in the young group was significantly more than that in the older group(P=0.001).The 2PN fertilization rate,the 2PN cleavage rate,the rate of high-quality embryo and the rate of utilized embryos of young patients were higher than those of old patients,without statistically significant difference.The rate of no available oocytes and the cycle cancellation rate of the young group was lower than that of the old group,without statistically significant difference.Conclusion:The PPOS protocol is effective for patients with POR,more significant for young patients.