不同促排卵方案在子宫内膜异位症合并不孕患者体外受精治疗中的效果比较

Comparison of the Effects of Different Ovulation Induction Regimens on In Vitro Fertilization in Patients with Endometriosis Complicated with Infertility

目的研究不同促排卵方案在子宫内膜异位症合并不孕患者体外受精治疗中的效果。方法选取2017年6月-2021年5月在我院接受体外受精治疗的子宫内膜异位症伴不孕患者112例,采用随机数字表法分为观察组和对照组,每组56例。观察组予以拮抗剂促排卵方案,对照组予以超长促排卵方案,比较两组临床指标(GnRH-a使用总量、获卵数量、注射hCG时子宫内膜厚度、优胚数量、胚胎移植数量、胚胎冷冻数量)与临床结局(种植、妊娠、流产、异位妊娠)。结果观察组体外受精治疗中GnRH-a使用总量、获卵数量少于对照组,注射hCG时子宫内膜厚度低于对照组(P<0.05);而两组优胚数量、胚胎移植数量与胚胎冷冻数量、种植比例、妊娠比例、流产比例、异位妊娠比例比较,差异无统计学意义(P>0.05)。结论拮抗剂促排卵方案与超长促排卵方案在子宫内膜异位症合并不孕患者体外受精治疗中临床结局无明显差异,但拮抗剂促排卵方案GnRH-a使用总量更少,临床可结合患者实际情况合理选择不同促排卵方案。

Objective To study the effect of different ovulation induction regimens on in vitro fertilization in patients with endometriosis complicated with infertility.Methods A total of 112 patients with endometriosis and infertility who received in vitro fertilization in our hospital from June 2017 to May 2021 were divided into observation group and control group by random number table method,with 56 cases in each group.The observation group was given an antagonist ovulation promotion program,and the control group was given an ultra-long ovulation promotion program.The clinical indicators(total amount of GnRH-a used,number of eggs harvested,endometrial thickness when hCG injected,number of excellent embryos,retrieved oocyte number,number of embryos frozen)and clinical outcomes(implantation,pregnancy,abortion,ectopic pregnancy)were compared between the two groups.Results The total amount of GnRH-a and retrieved oocyte number in the observation group were less than those in the control group,and the endometrial thickness at hCG injection was lower than that in the control group(P<0.05).There was no significant difference between the two groups in the number of excellent embryos,the number of embryos transferred and the number of frozen embryos,implantation rate,pregnancy rate,abortion rate and ectopic pregnancy rate(P>0.05).Conclusion There is no significant difference in the clinical outcome between the antagonist ovulation promotion program and the ultra-long ovulation promotion program in the in vitro fertilization treatment of patients with endometriosis and infertility.However,the total amount of GnRH-a used in the antagonist ovulation induction protocol is less.Different ovulation induction protocols can be reasonably selected according to the actual situation of patients.