早卵泡期和晚卵泡期添加黄体生成素对多囊卵巢综合征GnRH-a长方案卵巢慢反应患者临床结局的影响

Effects of luteinizing hormone at different stages on clinical outcomes of polycystic ovary syndrome patients with suboptimal ovarian response to GnRH-a long protocol

目的观察早卵泡期和晚卵泡期添加黄体生成素对多囊卵巢综合征促性腺激素释放激素激动剂(GnRH-a)长方案卵巢慢反应患者临床结局的影响。方法回顾性分析2017年1月至2019年1月营口市妇产儿童医院产科收治的96例多囊卵巢综合征患者的临床资料,按照是否加用尿促性腺激素及早、晚卵泡期分为三组:A组、B组和C组,每组各32例。A组患者未加用尿促性腺激素,B组患者在早卵泡期添加尿促性腺激素,C组患者在晚卵泡期添加尿促性腺激素。比较三组患者的临床结局(优胚数、受精数、获卵数、胚胎植入成功率、临床妊娠率、可利用胚胎数)。结果A组患者的优胚数、受精数、获卵数、胚胎植入成功率、临床妊娠率、可利用胚胎数依次为(4. 61±3. 14)个、(7. 79±4. 64)个、(11. 07±4. 35)个、59. 37%、62. 5%、(4. 51±2. 83)个;B组患者的优胚数、受精数、获卵数、胚胎植入成功率、临床妊娠率、可利用胚胎数依次为(4. 83±3. 29)个、(8. 07±4. 89)个、(14. 05±4. 41)个、84. 37%、87. 50%、(6. 34±2. 62)个;C组患者的优胚数、受精数、获卵数、胚胎植入成功率、临床妊娠率、可利用胚胎数依次为(4. 78±3. 33)个、(7. 88±4. 74)个、(11. 17±4. 23)个、56. 25%、65. 62%、(4. 42±2. 79)个。三组患者的优胚数、受精数比较,差异无统计学意义(P>0. 05);与A组、C组比较,B组患者的获卵数、临床妊娠率、胚胎植入成功率、可利用胚胎数明显更高,差异具有统计学意义(P <0. 05)。结论早卵泡期适当添加黄体生成素可有效改善多囊卵巢综合征GnRH-a长方案卵巢慢反应患者的妊娠结局,值得推广应用。

Objective To observe the effects of applying luteinizing hormone in the early or late follicular phase on the clinical outcome of patients with polycystic ovary syndrome with suboptimal ovarian response to gonadotropin-releasing hormone agonist( GnRH-a) long protocol.Methods The clinical data of 96 patients with polycystic ovary syndrome admitted to the obstetrics department of Yingkou City Maternity and Children’s Hospital from January 2017 to January 2019 were retrospectively analyzed. They were divided into three groups: group A,group B and group C,32 cases in each group. Patients in group A were not applied with urinary gonadotropin,patients in group B were applied with urinary gonadotropin in the early follicular phase,and patients in group C were applied with urinary gonadotropin in the late follicular phase. The clinical outcomes( number of superior embryos,number of fertilization,number of eggs obtained,embryo implantation rate,clinical pregnancy rate,and number of available embryos) were compared among the three groups. Results The number of superior embryos,fertilization,egg obtained,embryo implantation rate,clinical pregnancy rate,and available embryos were( 4. 61 ± 3. 14),( 7. 79 ± 4. 64),and( 11. 07 ± 4. 35),59. 37%,62. 5%,and( 4. 51 ± 2. 83) in group A;( 4. 83 ± 3. 29),( 8. 07 ± 4. 89),( 14. 05 ± 4. 41),84. 37%,87. 50%,and( 6. 34 ± 2. 62) in group B;and( 4. 78 ± 3. 33),( 7. 88 ± 4. 74),( 11. 17 ± 4. 23),56. 25%,65. 62%,and( 4. 42 ± 2. 79) in group C. There was no significant difference in the number of superior embryos and fertilization among the three groups( P > 0. 05). Compared with group A and group C,the number of eggs obtained,clinical pregnancy rate,embryo implantation rate and number of available embryos in group B were significantly higher,and the differences were statistically significant( P < 0. 05). Conclusion Appropriate applying luteinizing hormone in the early follicular phase can effectively improve the pregnancy outcome of polycystic ovary syndrome patients with suboptimal ovarian response to GnRH-a long protocol,and it is worth popularizing.