高孕激素超促排卵方案中基础LH水平对PCOS患者IVFICSI治疗结局影响

Effect of the basic LH level in the high progesterone ovulation program on the outcome of IVFICSI treatment for PCOS patients

目的:分析高孕激素超促排卵方案中基础LH水平对PCOS患者IVFICSI治疗结局的影响。方法:回顾性分析海南医学院第二附属医院200例PCOS患者根据不同的LH水平随机分为A、B、C三组,三组均采用促性腺激素(Gn)联合安宫黄体酮(MPA)的高孕激素超促排卵方案治疗,其中A、B、C三组的LH水平分别为0 IU～5IU/L、5 IU～10IU/L和> 10IU/L。分析比较三组患者在治疗结局的差异。结果:三组患者在年龄、月经周期、不孕年限、BMI、既往失败次数、基础卵泡数和不孕因素(包含合并输卵管和男方因素)差异无统计学意义(P> 0. 05);基础FSH、LH和E2指标差异具有统计学意义(P <0. 05)。Gn用量、Gn用药天数、正常受精卵数、优质胚胎数、有效胚胎数和周期取消率变化均不明显,差异无统计学意义(P> 0. 05);获卵数、成熟卵数和成熟卵率变化明显,差异具有统计学意义(P <0. 05)。A、B、C三组患者的临床妊娠率分别为59. 2%、68. 9%和62. 5%,差异无统计学意义(P> 0. 05)。早期流产率、继续妊娠率均无明显变化,差异无统计学意义(P> 0. 05)。结论:高孕激素超促排卵方案在对PCOS患者进行IVFICSI治疗时,能够有效预防自发性LH峰发生,并且可促进卵组获得具有发育潜能的胚胎,在临床中值得推广应用。

Objective:To study the effect of the basic LH level in the high progesterone ovulation program on the outcome of IVFICSI treatment for PCOS patients.Methods:200 PCOS patients that received high progesterone superovulation scheme of gonadotropin(Gn)combined with progesterone(MPA)were divided into group A,B and C.The LH level of group A,B and C was 0-5IU/L,5-10IU/L and>10IU/L respectively.The differences in treatment outcomes were compared between the three groups.Results:There was no statistically significant difference in age,menstrual cycle,infertile years,BMI,number of times of previous failure,basal follicles and infertility factors(including tubal and male factors(P>0.05).Differences in basic FSH,LH and E2 indexes were statistically significant(P<0.05)Differences in the Gn dosage,number of days of Gn administration,number of normal fertilized eggs,number of high quality embryo,number of effective embryo and cycle cancellation rate were not statistically significant(P>0.05).Differences in the number of eggs obtained,the number of mature eggs and rate of mature eggs were statistically significant(P<0.05).The clinical pregnancy rate of group A,B and C was 59.2%,68.9%and 62.5%respectively(P>0.05).There was no significant change in early abortion rate and continuing pregnancy rate(P>0.05).Conclusions:High progesterone superovulation scheme can prevent spontaneous LH peaks and promote the developmental potential of embryos in IVFICSI treatment for PCOS patients,worthy of clinical promotion.