重组人生长激素对不同年龄段卵巢储备功能低下患者IVF-ET治疗结局的影响

Effect of recombinant human growth hormone on the outcome of IVF-ET in patients with low ovarian reserve function at different ages

目的探讨重组人生长激素对不同年龄段卵巢储备功能低下患者体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法抽取2017年1月至2019年12月于洛阳市中心医院行IVF-ET治疗的卵巢储备功能低下患者90例,均接受促性腺激素释放激素激动剂常规长方案降调节并给予重组人生长激素治疗,将其设为研究组。另抽取同期单纯开展常规长方案降调节治疗的卵巢储备功能低下患者90例作为对照组。分析两组患者基础资料及实验室检查结果、妊娠结局,总结不同年龄段卵巢储备功能趋于低下患者使用重组人生长激素的临床效果。结果不同年龄段患者不孕年限、基础卵泡刺激素、窦卵泡数,两组比较差异未见统计学意义(P>0.05)。<35岁者,研究组促性腺激素(Gn)使用时间及Gn使用总量略低于对照组,获卵数略高于对照组,但差异未见统计学意义(P>0.05);≥35岁者,研究组Gn使用时间及Gn总量低于对照组,人绒毛膜促性腺激素(HCG)注射日雌二醇(E2)、获卵数高于对照组,差异有统计学意义(P<0.05)。不同年龄段研究组种植率、妊娠率略高于对照组,但差异未见统计学意义(P>0.05)。结论卵巢储备功能低下随着患者年龄的增长逐渐加重,≥35岁者使用重组人生长激素对IVF-ET治疗具有一定影响,可改善患者的卵巢反应性,提高HCG注射日E2水平,增加获卵数。

Objective To investigate the effect of recombinant human growth hormone on the outcome of in vitro fertilization-embryo transfer(IVF-ET)in patients with low ovarian reserve function at different ages.Methods A total of 90 patients with low ovarian reserve function who underwent IVF-ET treatment in Luoyang Central Hospital from January 2017 to December 2019 were selected.All of them received conventional long-acting down-regulation of gonadotropin-releasing hormone agonists,and were treated with recombinant human growth hormone,and they were set as the research group.Another 90 patients with low ovarian reserve function who were treated with conventional long-acting down-regulation therapy alone during the same period were selected as the control group.The general information,laboratory test results and pregnancy outcomes of the two groups were analyzed,and the clinical effects of recombinant human growth hormone on patients with low ovarian reserve function at different ages were summarized.Results There was no significant difference in infertility duration,basal follicle stimulating hormone,and antral follicle count among patients of different ages between the two groups(P>0.05).For patients<35 years old,the use time of gonadotropin(Gn)and the total amount of Gn in the study group were slightly lower than those in the control group,and the number of oocytes retrieved was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).For patients≥35 years old,the Gn usage time and Gn total amount in the study group were lower than those in the control group,while the estradiol(E2)on the day of human chorionic gonadotropin(HCG)injection and the number of oocytes retrieved in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The implantation rate and pregnancy rate of patients of different ages in the study group were slightly higher than those in the control group,but the difference was not statistically significant(P>0.05).Conclusions The low ovarian reserve function gradually worsens with the increase of age of patients.The use of recombinant human growth hormone in patients≥35 years old has a certain impact on IVF-ET treatment.It can improve ovarian responsiveness,increase E2 level on the day of HCG injection,and increase the number of oocytes retrieved.