PPOS方案和拮抗剂方案在高龄低反应患者临床结局对比分析

Comparative Analysis of the Clinical Outcomes of PPOS Regimen and Antagonist Regimen in the Elderly Patients with Low Response

目的:探究对高龄低反应患者应用高孕激素状态下促排卵方案(PPOS方案)、拮抗剂方案治疗的效果.方法:回顾性分析广西贵港市人民医院生殖中心2017年1月-2018年1月收治的80例符合体外受精-胚胎移植治疗的高龄低反应患者的临床病例资料.按促排卵方案不同分为两组,观察组30例患者采用PPOS促排卵方案,对照组50例患者采用拮抗剂促排卵方案.对比两组Gn(果纳芬或HMG)使用时间、Gn使用总量、获卵数、优质胚胎率、早发LH峰率、胚胎种植率、生化妊娠率、临床妊娠率、活产率.结果:两组Gn使用时间、获卵数比较差异无统计学意义(P>0.05);观察组Gn使用总量少于对照组,差异有统计学意义(P<0.05);观察组优质胚胎率、胚胎种植率、生化妊娠率、临床妊娠率、活产率高于对照组,但组间比较差异无统计学意义(P>0.05);观察组早发LH峰率(0)低于对照组(3.48%),差异有统计学意义(P<0.05).结论:对高龄低反应患者应用PPOS方案治疗的效果较拮抗剂方案更优,可有效预防LH峰早发,并可在一定程度上减少Gn使用总量,对减轻患者经济负担具有较积极的影响.

Objective:To explore the effect of PPOS regimen and antagonists regimen on the elderly patients with low response.Method:A retrospective analysis was made of the clinical data of 80 cases of low response elderly patients treated by IVF-ET from January 2017 to January 2018 in the reproductive center of Guigang People’s Hospital,Guangxi Province.According to the different ovulation promotion schemes,the patients were divided into two groups,30 patients in the observation group were treated with PPOS regimen,50 patients in control group were treated with antagonists regimen.The Gn(fenafen or HMG)use time,total Gn use,number of eggs acquired,high quality embryo rate,early LH peak rate,embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate,live birth rate were compared between the two groups.Result:There was no significant difference in Gn use time and number of eggs acquired between the observation group and the control group(P>0.05).The total amount of Gn use in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The high-quality embryo rate,embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate and live birth rate in the observation group were higher than those in the control group,but there was no significant difference between the two groups(P>0.05).The peak rate of LH in the observation group(0)was lower than that in the control group(3.48%),the difference was statistically significant(P<0.05).Conclusion:The treatment effect of PPOS is better than that of antagonist,which can effectively prevent the early onset of LH peak,reduce the total amount of GN use to a certain extent,and have a positive impact on reducing the economic burden of patients.