不同卵巢刺激方案应用于POSEIDONⅣ组人群的疗效

Effects of different ovarian stimulation schemes in POSEIDON Group Ⅳ population

目的评价不同卵巢刺激方案在POSEIDONⅣ组人群的应用效果。方法回顾性分析体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)助孕的POSEIDONⅣ组患者临床资料,按卵巢刺激方案分组:A组(黄体期长方案,n=50)、B组(拮抗剂,n=153)、C组(PPOS,n=182),比较不同方案临床疗效。结果与拮抗剂和PPOS方案相比,黄体期长方案能够获得更多的卵子数、MII数、优胚数、可利用胚胎数(P<0.05),更低周期取消率(P=0.009),更高的累积妊娠率(P=0.004);黄体期长方案和拮抗剂方案到达妊娠时间显著早于PPOS方案(P<0.001)。结论从增加可利用胚胎数、提高累积妊娠率、缩短到达妊娠时间来看,POSEIDONⅣ组人群采用黄体期长方案具有更大的优势,但临床工作中也需结合患者自身特点制定个体化治疗方案。

Objective To evaluate the application effects of different ovarian stimulation schemes in POSEIDON Group Ⅳ population.Methods Retrospective analysis was conducted on the clinical data of patients who received in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).These patients were classified by the fourth group of POSEIDONG criteria.According to the ovarian stimulation schemes,the patients were divided into Group A(luteal phase microreduction regulation protocol,n=50),Group B(antagonist protocol,n=153),and Group C(Progestin-primed ovarian stimulation,n=182).The clinical outcomes were compared among different protocols.Results Compared with the other groups,the Group A was associated with higher oocyte number,higher mature oocytes numbers,higher excellent embryos numbers and higher available embryos numbers,and lower cycle cancellation rate(P=0.009).The Group A has significantly higher cumulative pregnancy rate than Group B and C(P=0.004).The arrival time of pregnancy in Group A and B was significantly earlier than Group C(P<0.001).Conclusion The luteal phase microreduction regulation scheme may have greater advantages for POSEIDON Group Ⅳ population in increasing the number of available embryos and the cumulative pregnancy rate,and shortening the time to reach pregnancy.But it is also necessary to formulate an individualized treatment scheme according to the characteristics of patients in clinic.