不同扳机方式对多囊卵巢综合征患者新鲜周期移植妊娠结局的影响比较

Effects of different trigger methods on pregnancy outcomes of IVF-ET in patients with polycystic ovary syndrome

目的比较不同扳机方式对多囊卵巢综合征患者在新鲜周期移植妊娠结局的影响。方法回顾性分析中国人民解放军陆军第七十三集团军医院生殖医学中心2017年1月至2020年6月收治的多囊卵巢综合征并行体外受精-胚胎移植(IVF-ET)助孕的患者255例,在助孕过程中根据不同扳机方式分为:人绒毛膜促性腺激素(HCG)扳机组(HCG扳机组,81例)和促性腺激素释放激素激动剂(GnRH-a)联合低剂量HCG扳机组(联合扳机组,174例)。比较两组的一般资料、获卵数、可利用胚胎数、MⅡ卵率、临床妊娠率、持续妊娠率、早期流产率及卵巢过度刺激综合征(OHSS)发生率。采用t检验、χ^(2)检验进行统计分析。结果两组间获卵数、可利用胚胎数、MⅡ卵率、临床妊娠率、持续妊娠率、早期流产率比较,差异均无统计学意义(均P>0.05)。HCG扳机组的OHSS总发生率(6.17%,5/81)低于联合扳机组(0),差异有统计学意义(χ^(2)=10.956,P=0.001)。结论在多囊卵巢综合征患者行新鲜周期IVF-ET助孕过程中,GnRH-a联合低剂量HCG扳机更优,能减少OHSS的发生。

Objective To compare the effects of different trigger methods on the pregnancy outcomes of in vitro fertilization and embryo transfer(IVF-ET)in patients with polycystic ovary syndrome.Methods Two hundred and fifty-five patients with polycystic ovary syndrome who took IVF-ET assisted fertilization in Reproductive Medicine Center,Hospital of 73rd Army Group of Land Force,People's Liberation Army of China were retrospectively analyzed.According to the trigger methods,they were divided into a human chorionic gonadotropin(HCG)trigger group(HCG trigger group;81 cases)and a gonadotropin releasing hormone agonist(GnRH-a)combined with a low dose of HCG trigger group(combined trigger group;174 cases).The general data,numbers of eggs obtained,numbers of available embryos,rates of MⅡ eggs,clinical pregnancy rates,sustained pregnancy rates,early abortion rates,and incidences of ovarian hyperstimulation syndrome(OHSS)were compared between the two groups.t and χ^(2) tests were applied.Results There were no statistical differences in the number of eggs obtained,the number of available embryos,the rate of MⅡ eggs,the rate of clinical pregnancy,the rate of sustained pregnancy,and the rate of early abortion between the two groups(all P>0.05).The total incidence of OHSS of the combined trigger group was 6.17%(5/81),which was lower than that of the HCG trigger group(0),with a statistical difference(χ^(2)=10.956,P=0.001).Conclusion In patients with polycystic ovary syndrome undergoing a fresh cycle IVF-ET,GnRH-a combined with a low-dose HCG trigger is relatively better,and can reduce the occurrence of OHSS.