DOR患者IVF–ET周期中应用微刺激方案和PPOS方案的临床疗效比较

Comparison of Clinical Efficacy between Microstimulation Scheme and PPOS Scheme in IVF-ET Cycle of Patients with DOR

目的:探究卵巢储备功能减退(DOR)患者体外受精(IVF)–胚胎移植(ET)周期中应用微刺激方案和高孕激素状态下促排卵(PPOS)方案的临床疗效。方法:选取2019年1月至2020年12月于徐州市妇幼保健院生殖中心行IVF–ET治疗的72例DOR患者作为研究对象,回顾性分析其临床资料,根据其不同促排卵方案分为观察组与对照组,各36例。观察组患者采用PPOS方案促排卵,对照组患者采用微刺激方案促排卵。观察两组患者促排卵情况、人绒毛膜促性腺激素(HCG)注射日血清性激素水平、临床妊娠结局。结果:观察组患者促性腺激素(Gn)使用量、获卵数、可利用胚胎数多于对照组,Gn使用时间长于对照组,差异具有统计学意义(P<0.05)。观察组患者HCG注射日血清雌二醇(E2)、孕酮(P)、黄体生成素(LH)水平均高于对照组,差异具有统计学意义(P<0.05)。观察组患者临床妊娠率高于对照组,周期取消率低于对照组,差异具有统计学意义(P<0.05)。两组患者早期流产率比较,差异无统计学意义(P>0.05)。结论:PPOS方案是一种可行且有效的促排卵方案,在DOR患者IVF–ET周期中应用PPOS方案可争取更多的妊娠机会,获得比较满意的临床妊娠结局,为DOR患者促排卵提供新的选择方案。

Objective To explore the clinical efficacy of microstimulation and progestin primed ovarian stimulation(PPOS during in vitro fertilization(IVF)-embryo transfer(ET)cycle in patients with diminished ova-rian reserve(DOR).Methods A total of 72 patients with DOR who underwent IVF-ET treatment in the reproductive center of Xuzhou Maternal and Child Health Hospital from January 2019 to December 2020 were selected as the study objects.Their clinical data were retrospectively analyzed,and they were divided into an observation group and a control group according to different ovulation promotion schemes,with 36cases in each group.The patients in the observation group received PPOS scheme and the control group received microstimulation scheme.Ovulation induction,serum sex hormone level on human chorionic gonadotropin(HCG)injection day and clinical pregnancy outcome were observed in the two groups.Results The consumption of gonadotropin(Gn),the number of eggs harvested and the number of available embryos in the observation group were higher than those in the control group,and the use time of Gn was longer than that in the control group,with statistical significance(P<0.05).The levels of serum estradiol(E2),progesterone(P)and luteinizing hormone(LH)on HCG injection day in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The clinical pregnancy rate of the observation group was higher than that of the control group,and the cycle cancellation rate was lower than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the early abortion rate between the two groups(P>0.05).Conclusion PPOS scheme is a feasible and effective ovulation induction scheme.The application of PPOS scheme in the IVF-ET cycle of patients with DOR can strive for more pregnancy opportunities and obtain satisfactory clinical pregnancy outcome,which provides a new choice for ovulation induction in patients with DOR.