非垂体降调节促排卵方案在卵巢储备功能正常不孕患者体外受精中的应用及对患者卵细胞质量的影响

Application of non-pituitary down-regulation ovulation induction regimen in IVF in patients with normal ovarian reserve function and its effect on egg cell quality

目的探讨非垂体降调节促排卵方案在卵巢储备功能正常患者体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)中的应用及对患者卵细胞质量的影响。方法选取2016年6月至2017年6月冀中能源峰峰集团总医院收治的84例卵巢储备功能正常的不孕患者,采用随机数字表法分为对照组和研究组,各42例,对照组应用促性腺激素释放激素激动剂(gonadotropin releasing hormone agonist,GnRH-a)长方案,研究组应用非垂体降调节促排卵方案。对比两组获卵数、第2次分裂中期(MetaphaseⅡ,MⅡ)卵数、2 PN受精卵数、卵细胞质量、卵子成熟率、2 PN受精率、优质胚胎率、可利用胚胎率、冷冻胚胎周期率、胚胎种植率、临床妊娠率。结果研究组2 PN受精卵数、2 PN受精率、胚胎种植率及临床妊娠率与对照组比较差异无统计学意义(P>0.05),获卵数和MⅡ卵数与对照组比较,差异有统计学意义(P<0.05),研究组卵子成熟率、优质胚胎率及可利用胚胎率明显高于对照组,治疗费用低于对照组(P<0.05)。结论在卵巢储备功能正常患者IVF-ET中,非垂体降调节促排卵方案可使卵细胞质量、优质胚胎率和可利用胚胎率明显提高,且对患者胚胎种植率和临床妊娠率没有明显影响,适宜临床推广应用。

Objective To explore the application of non-pituitary down-regulation ovulation induction protocol in IVF-ET of patients with normal ovarian reserve function and its effect on the quality of ovarian cells.Methods 84 cases of infertility with normal ovarian reserve in General Hospital of Jizhong Energy Fengfeng Group from June 2016 to June 2017 were selected and divided into control group and study group by random number table method.The control group was given GnRH-a long-term regimen and the study group was given non-pituitary down-regulation ovulation stimulation regimen.The oocyte quality,oocyte maturation rate,2 PN fertilization rate,high quality embryo rate,available embryo rate,frozen embryo cycle rate,embryo implantation rate and clinical pregnancy rate were compared between the two groups.Results There were no significant difference in the number of 2 PN fertilized eggs,2 PN fertilization rate,embryo implantation rate and clinical pregnancy rate between the study group and the control group(P>0.05).The number of eggs obtained and the number of MⅡeggs in the study group were significantly different from those of the control group(P<0.05),the egg maturation rate,high quality embryo rate and available embryo rate in the study group were significantly higher than those in the control group,and the treatment cost was significantly lower than that of the control group(P<0.05).Conclusion In IVF-ET patients with normal ovarian reserve function,non-pituitary down-regulation ovulation induction program can significantly improve the quality of ovarian cells,high-quality embryo rate and available embryo rate,and has no significant impact on the implantation rate of patients with embryo and clinical pregnancy rate,suitable for clinical application.