摘要
目的探讨卵巢低反应者行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕治疗时,在拮抗剂方案中地屈孕酮预处理对卵泡均匀性的影响。方法分析促排卵前一月经周期黄体中期行地屈孕酮预处理组(A组)73例和未行预处理对照组(B组)118例患者,对其月经第2天(D2)卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2),促性腺激素(Gn)天数、用量,拮抗剂天数、用量,注射人绒毛膜促性腺激素(HCG)日E_2、LH、孕激素(P)、子宫内膜厚度、卵泡不同步率(将最大卵泡与次大卵泡平均直径相差≥3 mm则视为不同步)、回收卵数、受精率、优胚率、着床率、临床妊娠率、继续妊娠率等进行对比观察。结果与B组相比,A组D2 FSH下降[(7.75±4.03)vs.(9.28±4.08)IU/L,P=0.012];A组HCG日E_2增加L(4,593.39±2,334.35)vs.(3,784.94±2,065.36)pmol/L,P=0.013],回收卵数增加[(5.29±3.03)vs.(4.31±3.18)枚,P=0.036];A组Gn启动第7日卵泡不均匀率(16.44%vs.31.36%,P=0.022)及HCG日卵泡不均匀率(23.29%vs.37.29%,P=0.044)均下降。结论地屈孕酮预处理可促进卵泡发育的均匀性。
Objective： To investigate the influence of pretreatment with dydrogesterone in previous mid-luteal phase on homogeneity of follicular size during in vitro fertilization and embryo transfer （IVF-ET） in low responders with GnRH antagonist protocol. Methods： A total of 191 patients undergone IVF were prospectively randomized into dydrogesterone pretreatment group （group A, n： 73） and non-pretreatment group as control group （group 13, n： 118）. The homogeneity of growing follicles was observed. Follicular stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （E2） on Day 2, gonadotropin （Gn） duration and dosage, antagonist duration and dosage, E2 ,progesterone（P）and LH levels and endometriaI thickness on HCG day, number of oocytes retrieved, fertilization rate, high-quality embryo rate, implantation rate, clinical pregnancy rate and ongoing pregnancy rate were compared between the two groups. Results： Compared with group B,the FSH levels on Day 2[-（7.75±4.03） vs. （9.28±4.08）IU/L,P= 0.0121 were significantly decreased in group A. The E21evels[-（4, 593. 39 ±2, 334. 35） vs. （3,784.94± 2,065.36） pmol/L,P=0. 0131 on HCG day and the number of oocytes retrieved[-（5.29±3.03） vs. （4.31 !3.18）,P=0. 0361 were significantly increased,but the follicular non-uniform rate on the 7th day of Gn administration （16.44% vs. 31.36%,P=0. 022） and on the day of HCG injection （23.29% vs. 37.29%,P=0. 044） significantly reduced in the group A. Conclusions. Pretreatment with dydrogesterone in previous middle luteal phase can improve homogeneity of growing ovarian follicles.
出处
《生殖医学杂志》
CAS
2013年第10期806-810,共5页
Journal of Reproductive Medicine
