摘要
目的：探讨在体外受精-胚胎移植（in vitro fertilization embryo transfer, IVF-ET）超促排卵中，促性腺激素（gonadotropin，Gn）用药时间对妊娠结局的影响。方法： 对2012年1~12月在北京大学第三医院生殖医学中心行IVF-ET助孕，促性腺激素释放激素激动剂（gonadotropin releasing hormone agonist，GnRH-a）短方案和促性腺激素释放激素拮抗剂（gonadotropin releasing hormone antagonist，GnRH-ant）方案的患者共3 221例进行回顾性分析。Gn用药时间小于等于7 d的患者为A组（n=58），Gn用药时间大于7 d为B组（n=3 163），比较两组患者年龄、不孕年限、体重指数、基础雌二醇（estradiol，E2）、促卵泡生成素（follicle-stimulating hormone，FSH）、窦卵泡数、获卵数、人绒毛膜促性腺激素（human chorionic gonadotropin，HCG）日子宫内膜厚度、受精率、优胚率、着床率及临床妊娠率等。结果：年龄、不孕年限、体重指数、基础E2、FSH、窦卵泡数两组间比较差异无统计学意义。A组获卵数少于B组［（8.2±5.6）vs.（12.1±8.3），P=0.009］；HCG：日子宫内膜厚度A组小于B组［（9.9±2.1）mm vs.（10.4±1.6） mm，P=0.002］。两组间受精率、优胚率及着床率差异无统计学意义，临床妊娠率差异无统计学意义（36.2% vs. 33.6%，P〉 0.05）。A组中GnRH-a短方案18例，6例临床妊娠（33.3%），B组中GnRH-a短方案1 019例，277例临床妊娠（27.2%），临床妊娠率差异无统计学意义；A组中GnRH拮抗剂方案40例，15例临床妊娠（37.5%），B组中GnRH拮抗剂方案2 144例，785例临床妊娠（36.6%），临床妊娠率差异亦无统计学意义。结论：在IVF-ET中，应用GnRH-a短方案和GnRH拮抗剂方案Gn用药时间短的患者尽管获卵数较少，但最终妊娠结局未受到影响。
To investigate the influence of duration of gonadotropin （Gn） administration on the clinical outcome of in vitro fertilization embryo transfer （IVF-ET）. Methods： A total of 3 221 cycles of short protocol or antagonist protocol in our center from January 2012 to December 2012 were included in the retrospective study. According to the different duration of Gn administration, all patients were divided into group A （≤7 days, n=58） and group B （〉7 days, n=3 163）. The different clinical parameters, such as age, duration of infertility, body mass index （BMI）, basis estradiol （E 2）, folliclestimulating hormone （FSH）, the number of antral follicle, the number of oocytes, endometrium thickness, fertility rate, good quality embryo rate, impatation rate and clinical pregnancy rate were compared between the two groups.Results： There was no significant difference in age, duration of infertility, BMI, basis E 2, FSH, the number of antral follicle between the two groups. The number of oocytes in group A was fewer than that in group B [（8.2±5.6）vs.（12.1±8.3）,P=0.009]; endometrium thickness on the day of HCG in group A was thinner than that in group B [（9.9±2.1） mm vs.（10.4±1.6） mm,P=0.002]. There was no significant difference in fertility rate, good quality embryo rate, impatation rate and clinical pregnancy rate （36.2% vs. 33.6%, P〉 0.05）. There was no significant difference in clinical pregnancy rate between the two groups in short protocol （33.3% vs. 27.2%, P〉 0.05）. In the same way, there was no significant difference in clinical pregnancy rate between the two groups in antagonist protocol （37.5% vs. 36.6%, P〉 0.05）. Conclusion： Although short duration of gonadotropin administration in short protocol and antagonist protocol has association with fewer number of oocytes, it may not affect the outcome of IVF- ET.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2013年第6期873-876,共4页
Journal of Peking University:Health Sciences
基金
"十二五"国家科技支撑计划(2012BAI32B01)项目
国家自然科学基金(81200413)资助~~
关键词
促性腺激素类
受精
体外
胚胎移植
妊娠率
Gonadotropins, Fertilization in vitro, Embryo transfer, Pregnancy rate
