GnRH-a长方案与拮抗剂方案在多囊卵巢综合征患者中的应用

GnRH-a long regimen and antagonist regimen in PCOS patients

目的比较GnRH-a长方案与拮抗剂方案在多囊卵巢综合征(PCOS)患者中的临床疗效与安全性,为临床PCOS患者合理选用超促排卵方案提供依据。方法选择240例需要进行控制性超促排卵治疗的PCOS患者为研究对象,随机分为2组,每组120例,A组采用GnRH-a长方案,B组采用拮抗剂方案。比较两组患者的临床结局。结果拮抗剂组患者的获卵数及人绒毛膜促性腺激素日雌激素水平低于GnRH-a长方案组,差异具有统计学意义(P<0.05),但其Gn总剂量与启动剂量低于GnRH-a长方案组(P<0.01),两组患者的优质胚胎率、妊娠率等临床结局差异无统计学意义(P>0.05)。安全性方面,拮抗剂组患者卵巢过度刺激综合征发生率及周期取消率低于GnRH-a长方案组,差异具有统计学意义(P<0.05)。结论拮抗剂超促排卵方案与GnRHa长方案的妊娠结局无明显差异,拮抗剂组患者卵巢过度刺激综合征发生率及周期取消率较低,其治疗也更经济。因此,拮抗剂方案可以考虑作为PCOS患者超促排卵的首选方案。

Objective To compare the clinical efficacy and safety of GnRH-a long regimen and antagonist regimen in PCOS patients.Methods A total of 240 PCOS patients requiring COH treatment were included.The patients were randomly divided into 2 groups,with 120 cases in each group.A group was treated with GnRH-a long program,and B group was treated with antagonist regimen.The clinical outcomes of the two groups were compared.Results In terms of clinical efficacy,the number of oocytes obtained and the estrogen level at HCG days of the antagonist regimen group were significantly lower than the GnRH-a long regimen group (P<0.05).The Gn total dose and Gn starting dose of the antagonist regimen group were significantly lower than the GnRH-a long regimen group (P<0.01).The difference of high quality embryo rate and pregnancy rate between the two groups was not significant (P>0.05).The antagonist regimen group had an obviously OHSS incidence and cycle cancellation rate,the difference was significant (P<0.05).Conclusion There is no significant difference between the two regimens.The antagonist regimen group has an obviously OHSS incidence and cycle cancellation rate.Its treatment is more economical.Thus,the antagonist regimen may be considered as the preferred COH regimen in PCOS patients.