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目的探讨GnRH拮抗剂方案和激动剂超短方案在卵巢低反应(POR)患者中的临床效果。方法回顾性分析了171例POR的184个IVF/ICSI周期,根据促排卵方案不同分为GnRH激动剂超短方案组(110个周期)和拮抗剂方案组(74个周期)。比较两组的基本资料及临床结局。结果两组HCG日雌激素值及子宫内膜厚度、获卵数、卵裂率、可移植胚胎率、优质胚胎率、周期取消构成比、流产率等差异均无统计学意义(P均>0.05);拮抗剂组促性腺激素(Gn)使用时间、Gn总量、HCG日LH值均低于激动剂超短方案组,而2PN受精率高于激动剂超短方案组,差异有统计学意义(P<0.05)。拮抗剂组周期取消率略低于激动剂超短方案组(23.0%vs.36.4%),胚胎种植率、移植周期妊娠率略高于超短方案组,但差异不具有统计学意义(P>0.05)。结论在POR患者中,GnRH拮抗剂方案可节约Gn用量、缩短Gn时间,降低经济成本,因此拮抗剂方案也是POR可以选择的、比较理想的促排卵方案。
Abstract：Objective:To assess the efficacy of GnRH antagonist(GnRH-ant)protocol and ultra-short GnRHagonist(GnRH-a)protocol in poor ovarian responders undergone IVF.Methods:A retrospective analysis was performed in a total of 171 patients with 184IVF/ICSI cycles.Among them,110 cycles were administered in ultra-short GnRH-aprotocol(group A),while 74 cycles were adopted GnRH-ant protocol(group B).The general conditions and the clinical outcomes of the two groups were compared.Results:There were no statistical differences in E2 levels and endometrial thickness on the day of HCG injection(HCG day),number of oocytes retrieved,cleavage rate,available embryo rate,high-quality embryo rate,cycle cancellation rate,and abortion rate between the two groups(P >0.05).Total gonadotropin(Gn)dose,duration of Gn used,LH levels on HCG day were significantly lower in group B than those in group A,and the 2PN fertilization rate in group B was significantly higher than that in group A(all P<0.05).The embryo implantation rate and clinical pregnancy rate were slightly higher(P>0.05),and the cycle cancellation rate was slightly lower in group B compared with group A(23.0% vs.36.4%,P=0.054),but there were no significant differences.Conclusions:In the poor ovarian responders,GnRH-ant protocol can decrease the Gn dosage,short the time of Gn used,and reduce the economic cost.GnRH-ant protocol is a alternative and avalid treatment protocol.
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基本信息:
中图分类号:R714.8
引用信息:
[1]杨菁,冯亭亭,孙伟,等.GnRH拮抗剂方案与激动剂超短方案应用于卵巢低反应患者的临床效果比较[J].生殖医学杂志,2016,25(09):794-798.
2016-09-15
2016-09-15