IVF/ICSI失败患者再次治疗时不同促排方案的临床分析

Clinical analysis of different ovulation promotion strategies in patients who have failed IVF/ICSI

目的体外受精/卵胞质内单精子显微注射(IVF/ICSI)失败患者再次促排卵时,比较微刺激促排卵方案和黄体期促排卵方案的临床疗效。方法回顾性分析在本院生殖中心接受IVF/ICSI助孕且具有IVF/ICSI失败史的不孕症患者的临床资料,根据促排卵方案不同分为黄体期促排卵方案组(98例)和微刺激促排卵方案组(n=551例),比较两组的基本情况、促排卵情况及妊娠结局。结果两组患者的年龄、不孕年限、体重指数(BMI)、基础FSH、原发不孕比例及IVF比例等基础资料差异无统计学意义(P>0.05);两组的Gn天数、获卵数、MII数、2PN数、可移植胚胎数、移植胚胎数差异也无统计学意义(P>0.05),但黄体期促排组的Gn量显著高于微刺激促排卵组,差异具有统计学意义(P<0.05),而两组的受精率、周期取消率、种植率和临床妊娠率差异均无统计学意义(P>0.05)。结论黄体期促排方案和微刺激方案在IVF/ICSI失败患者人群中具有相似的治疗效果。

Objective To compare clinical effects of mini-stimulation and luteal phase ovulation-inducing programs in patients with failure in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI). Methods The clinical data of infertile patients with a history of IVF/ICSI failure who received IVF/ICSI treatment at our reproductive center were retrospectively analyzed. They were divided into two groups according to the different stimulation protocols: luteal phase ovulation inducting protocol(98 cases), mini-stimulation protocol(551 cases). The differences in baseline data, ovulation-inducing situation and pregnancy outcome between the two groups were compared. Results There was no significant difference in age, duration of infertility, body mass index(BMI), the basic level of follicle stimulating hormone(FSH), proportion of primary infertility, and proportion of IVF between the two groups(P>0.05);There was also no significant difference in the duration of Gn, the number of retrieved oocytes, MII oocytes, 2 PN zygotes, transferable embryos, and transferred embryos between the two groups(P>0.05). But the total Gn dosage in the luteal phase ovulation-inducing group was significantly higher than that in the mini-stimulation group, and the difference was statistically significant(P<0.05). There was no significant difference in fertilization rate, cycle cancellation rate, implantation rate, and clinical pregnancy rate between the two groups(P>0.05). Conclusion The luteal phase ovulation-inducing and mini-stimulation protocols have similar therapeutic effects in patients with a history of IVF/ICSI failure.