枸橼酸氯米芬联合促性腺激素对IVF卵巢低反应者的影响

Effect of Clomifene Citrate Combined with Gonadotropin on IVF Patients with Poor Ovarian Response

目的:探讨枸橼酸氯米芬联合促性腺激素(Gn)对体外受精(IVF)卵巢低反应者的影响。方法:选取2017年1月-2021年3月泉州市妇幼保健院收治的152例行IVF治疗的卵巢低反应者作为研究对象。采用随机数表法分为研究组和对照组,各76例,对照组患者采用常规Gn启动措施,研究组采用枸橼酸氯米芬联合Gn启动措施。对比两组患者Gn用量及用药天数,人绒毛膜促性腺激素(HCG)注射日雌二醇(E_(2)),孕酮(P)和促黄体生成素(LH)水平及内膜厚度,平均获卵数,优质胚胎率,妊娠结局(生化妊娠率、临床妊娠率、持续妊娠率)。结果:研究组患者Gn用量明显少于对照组,用药天数明显短于对照组(P<0.05);在对患者注射HCG时,研究组血清中E_(2)及LH水平明显高于对照组,内膜厚度明显低于对照组(P<0.05);两组P水平比较差异无统计学意义(P>0.05);两组平均获卵数、优质胚胎率比较差异无统计学意义(P>0.05);研究组生化妊娠率为32.89%,明显高于对照组的18.42%(P<0.05);研究组临床妊娠率、持续妊娠率分别为23.68%、15.79%,与对照组的14.47%、6.58%比较差异均无统计学意义(P>0.05)。结论:在卵巢低反应者IVF助孕过程中应用枸橼酸氯米芬联合Gn启动,能够有效改善助孕结局,并能够降低Gn用量和使用天数,值得临床推广。

Objective:To explore the effect of Clomifene Citrate and Gonadotropin (Gn) on patients with poor ovarian response in vitro fertilization (IVF).Method:From January 2017 to March 2021,a total of 152 patients with poor ovarian response treated by IVF in Quanzhou Maternal and Child Health Hospital were selected as the study subjects.They were divided into the study group and the control group according to the random number table method,with 76 cases in each group.The control group used conventional Gn initiation treatment,and the study group used Clomifene Citrate combined with Gn initiation treatment.Gn dosage and the number of days of medication,estradiol (E_(2)),progesterone (P) and luteinizing hormone (LH) levels and intima thickness on the day of Human Chorionic Gonadotropin (HCG) injection,average number of eggs harvested,high quality embryo rate and pregnancy outcome (biochemical pregnancy rate,clinical pregnancy rate and sustained pregnancy rate) were compared between the two groups.Result:The Gn dosage in the study group was significantly less than that of the control group,and the number of days of medication was significantly shorter than that of the control group (P<0.05);when the patients were injected with HCG,the serum levels of E_(2)and LH in the study group were significantly higher than those in the control group,and the intimal thickness was significantly lower than that in the control group (P<0.05);there was no significant difference in P levels between the two groups (P>0.05);there was no significant difference in the average number of eggs harvested and the high quality embryo rate between the two groups (P>0.05);the biochemical pregnancy rate in the study group was 32.89%,which was significantly higher than 18.42% in the control group (P<0.05);the clinical pregnancy rate and the sustained pregnancy rate of the study group were 23.68% and 15.79% respectively,compared with 14.47% and 6.58% in the control group,the differences were not statistically significant (P>0.05).Conclusion:The application of Clomifene Citrate combined with Gn during IVF assisted pregnancy in patients with poor ovarian response,it can effectively improve the outcome of assisted pregnancy,and can reduce the Gn dosage and the number of days of medication,which is worthy of clinical promotion.