摘要
目的探讨3种不同助孕方案在≥40岁妇女体外受精-胚胎移植(IVF-ET)周期中的临床效果。方法回顾性分析2010年8月-2012年2月期间,于四川大学华西第二医院生殖中心行IVF-ET助孕、年龄≥40岁妇女共245个周期的临床资料,排除一侧卵巢缺如患者3例,余242个周期根据助孕方案不同分为3组:拮抗剂组(GnRH-A方案组)44个周期、长方案组109个周期及短方案组89个周期,比较3种方式助孕的临床效果。结果 3组均无早发黄体生成素峰;长方案组应用促性腺激素(Gn)的时间最长,应用Gn数量最多,获得最高的获卵数及获胚数(P<0.05);3组的受精率、优胚率、冷冻胚胎数、周期取消率、卵巢过度刺激综合征发生率、早期流产率均无统计学意义(P>0.05),短方案组的种植率及临床妊娠率最低(P<0.05)。结论 GnRH-a长方案在≥40岁妇女的IVF-ET周期中具有较好的临床结局,在≥40岁妇女IVF-ET周期中具有与长方案相似的结局,并且可以减少Gn使用量,提高卵泡及胚胎质量,短方案组对≥40岁妇女临床效果较差。
Objective To discuss the effect of three assisted reproductive protocols in patients at 40 years old or above undergoing in vitro fertilization and embryo transfer（IVF-ET） treatment.Methods The clinical data of 245 IVF cycles initiated in women 40 years old or above from August 2010 to February 2012 in the West China Second University Hospital were analyzed retrospectively.Three cycles keeping only one ovary were excluded and all the rest of 242 cycles were divided into 3 groups based on different assisted reproductive protocols： GnRH-A protocol group（44 cycles）,GnRH-a long protocol group（109 cycles） and GnRH-a short protocol group（89 cycles）.The clinical outcomes were compared between different protocols.Results None of the three groups had endogenous LH peak.GnRH-a long protocol group had the longest duration of gonadotrophin administration,used the most total dose of gonadotrophin,and obtained the highest number of eggs and embryos（P0.05）.There was no significant difference among the three groups in the fertility rate,the high-quality embryo rate,frozen embryo number,cycle cancellation rate,OHSS incidence and abortion rate（P0.05）.The GnRH-a short protocol group had the lowest implantation rate and clinic pregnancy rate（P0.05）.Conclusions GnRH-a long protocol has better clinical outcomes in IVF-ET cycles for women over 40 years old.The GnRH-A protocol can obtain similar effect,and can reduce the gonadotrophin usage and improve the quality of eggs and embryos.The effect of GnRH-a short protocol is poorer for women more than 40 years old.
出处
《华西医学》
CAS
2012年第12期1855-1858,共4页
West China Medical Journal
关键词
体外受精-胚胎移植
控制性超促排卵
促性腺激素释放激素拮抗剂
促性腺激素释放激素激动剂
In vitro fertilization and embryo transfer
Controlled ovarian hyperstimulation
Gonadotropin-releasing hormone agonist
Gonadotropin-releasing hormone antagonist
