卵巢正常反应患者添加r-LH卵泡期长方案与黄体期长方案临床效果比较

Comparison of clinical outcomes of patients with normal ovarian reaction between the long-acting GnRH-a long protocol added r-LH used in follicular phase and GnRH-a long protocol used in luteal phase

目的比较分析卵巢正常反应患者,添加重组人黄体生成素(r-LH)的早卵泡期长方案与黄体期短效长方案临床效果。方法采用前瞻性随机病例对照研究分析行体外受精-胚胎移植助孕的卵巢正常反应患者440周期,其中研究组为早卵泡期长方案(220周期),COS启动日血清LH≤1 IU/L患者,需添加r-LH;对照组为黄体期短效长方案(220周期),COS启动日血清LH水平> 1 IU/L,比较2组患者获MⅡ卵数、胚胎种植率、临床妊娠率等指标。结果研究组获MⅡ卵数、2PN受精率、优胚率、胚胎种植率、临床妊娠率、活产率及重度OHSS发生率明显高于对照组(P <0. 05),而全胚冷冻率低于对照组(P <0. 05)。结论在卵巢正常反应患者中,添加r-LH的早卵泡期长方案的临床效果可能略优于黄体期短效长方案。

Objective To compare the clinical outcomes of patients with normal ovarian reaction between the long-acting GnRH agonist(GnRH-a)long protocol added Recombinant Human Luteinizing Hormone(r-LH)used in follicular phase and short-acting GnRH-a long protocol used in luteal phase for ovarian stimulation in IVF cycles.Methods The data of 440 IVF cycles were prospectively randomized controlled.The cycles were divided into two groups:the patients in the study group were used long-acting GnRH-a long protocol used in follicular phase(n=220),if the serum LH was no more than 1 IU/L on the COS starting day in some patients,r-LH was added in the whole process,while the control group was the short-acting GnRH-a long protocol used in luteal phase(n=220),and whose serum LH level was more than 1 IU/L on the COS starting day.The clinical characters and outcomes were compared betwen the two group.Results The indexes of number of MⅡfollicles,2 PN fertility rate,high quality embryo rate,implantation rate,clinical pregnancy rate,live birth rate,the incidence of severe OHSS in the study group were significantly higher than those in the control group(P<0.05),The embryo frozen rate in the study group were significantly lower than that in the control group(P<0.05).Conclusion The clinical outcome of the long-acting GnRH-a long protocol added r-LH used in follicular phase may be better than that of the short-acting GnRH-a long protocol used in luteal phase for ovarian stimulation in IVF cycles in patients with normal ovarian reaction.