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目的探讨克罗米芬联合高孕激素状态促排卵方案在卵巢正常反应人群中的应用价值。方法回顾性分析2019年1～12月就诊本中心首次接受IVF-ET治疗的502例卵巢正常反应患者的临床资料,按促排方案不同分为高孕激素状态促排卵组(PPOS组,n=172)、克罗米芬联合高孕激素状态促排卵组(CC+PPOS组,n=168)及长方案组(n=162),统计分析3组患者的一般资料、促排卵指标及临床结局差异。结果 3组患者的一般情况比较均无显著性差异(P>0.05);促排卵指标比较中,长方案组患者使用促性腺激素(Gn)天数、Gn量、HCG日E2水平、获卵数、可移植胚胎数、优胚数均显著高于PPOS和CC+PPOS两组(P<0.05),而CC+PPOS组的Gn天数最短、Gn总量最低,显著低于长方案组和PPOS组(P<0.05);在治疗结局上,各组患者早发LH峰发生率、优胚率、累积妊娠率、早期流产率均无显著性差异(P>0.05),但长方案组的中重度卵巢过度刺激综合征(OHSS)发生率最高,显著高于其余两组(P<0.05)。结论 CC+PPOS方案在卵巢正常反应人群中运用有简单、经济、安全、有效的特点,可作为IVF促排方案选择之一。
Abstract：Objective:To investigate the application value progestin primed ovarian stimulation protocol combining with clomiphene citrate in normal ovarian responders.Methods:The data of 502 women with normal ovarian response who were undergone IVF-ET for the first time in our center from Jan. to Dec. 2019 were retrospectively analyzed. The patients were divided into three groups according to different protocols:progestin primed ovarian stimulation protocol group(PPOS group,n=172),clomiphene combined with progestin primed ovarian stimulation protocol group(CC+PPOS group,n=168) and long protocol group(n=162). The general information,the parameters of the controlled ovarian hyper-stimulation,and clinical outcome were compared among the three groups.Results:There was no significant difference in the general conditions among the three groups(P>0.05). The duration and total doses of gonadotropin(Gn) used,the level of E2 on HCG day,the number of oocytes retrieved,transferable embryos and high quality embryos in the long group were significantly higher than those in PPOS and CC+PPOS group(P<0.05). The CC+PPOS group had the shortest days and the lowest total doses of Gn,which were significantly lower than the long protocol group and PPOS group(P<0.05). No significant difference was found in the occurrence of premature LH peak,high quality embryos rate,the cumulative pregnancy rate and early abortion rate among the three groups(P>0.05). The incidence of moderate and severe ovarian hyper-stimulation syndrome(OHSS) in the long protocol group was significantly higher than that in other groups(P<0.05).Conclusions:The PPOS protocol combining with clomiphene citrate is simple,effective,less costing,and it may be a new optional protocol for ovarian stimulation in IVF among normal ovarian responders.
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基本信息:
中图分类号:R714.8
引用信息:
[1]沈亚,施蔚虹,丁家怡,等.克罗米芬联合高孕激素状态促排卵方案在卵巢正常反应人群中的应用[J].生殖医学杂志,2020,29(12):1576-1580.
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