生长激素在卵巢储备功能减退病人体外受精-胚胎移植拮抗剂方案中的临床应用

Clinical application of growth hormone in an in vitro fertilization-embryo transfer antagonist protocol in patients with diminished ovarian reserve function

目的探讨生长激素在卵巢储备功能减退(DOR)病人体外受精-胚胎移植(IVF-ET)拮抗剂方案中的作用。方法回顾性分析2019年10月至2021年9月在皖北煤电集团总医院生殖医学科行拮抗剂方案助孕的89例DOR病人(共97个周期)的临床资料。根据是否添加生长激素分为生长激素组(53个周期)和对照组(44个周期),比较两组的IVF-ET助孕结局。结果人绒毛膜促性腺激素(hCG)日A型子宫内膜[43.40%(23/53)]、优质胚胎率[73.79%(152/206)]、胚胎种植率[30%(27/90)]生长激素组显著高于对照组[29.55%(13/44)、60.81%(90/148)、17.07%(14/82)](P<0.05)。生长激素组与对照组临床妊娠率差异无统计学意义(P>0.05),logistic回归分析未发现生长激素与临床妊娠有关(β=0.85,P=0.132),而移植胚胎数与临床妊娠相关(β=1.33,P=0.029)。结论在IVF-ET拮抗剂方案的DOR病人中添加生长激素可以一定程度上提高胚胎质量,改善子宫内膜形态,增加胚胎种植率,但未发现其在提高临床妊娠率方面的明显作用。

Objective To investigate the effect of growth hormone(GH)on an in vitro fertilization and embryo transfer(IVF-ET)antagonist protocol in patients with diminished ovarian reserve(DOR).Methods The clinical data of 89 DOR patients(97 cycles in total)who an underwent antagonist protocol to assist conception from October 2019 to September 2021 in the Department of Reproductive Medicine of the General Hospital of Wanbei Coal-Electricity Group were retrospectively analyzed.The growth hormone group(53 cycles)and the control group(44 cycles)were categorized according to whether growth hormone was added,and the IVF-ET-assisted conception outcomes of the two groups were compared.Results The human chorionic gonadotropin(hCG)day A-type endometrium[43.40%(23/53)],the rate of high-quality embryos[73.79%(152/206)],and the rate of embryo implantation[30%(27/90)]in the growth hormone group were significantly higher than those in the control group[29.55%(13/44),60.81%(90/148),17.07%(14/82)](P<0.05).The difference in the clinical pregnancy rate between the growth hormone group and the control group was not statistically significant(P>0.05).Logistic regression analysis did not find that growth hormone was associated with clinical pregnancy(β=0.85,P=0.132),while the number of embryos transferred was associated with clinical pregnancy(β=1.33,P=0.029).Conclusion The addition of growth hormone to DOR patients on an IVF-ET antagonist protocol may improve embryo quality and endometrial morphology to a certain extent,increase the rate of embryo implantation,but no significant role in improving clinical pregnancy rates was found.