摘要
目的:比较不同促排卵方案在体外受精-胚胎移植中应用的有效性,为促排卵方案临床合理应用提供依据。方法:2013年1月至2015年6月在我院生殖医学中心接受长方案(599个周期)、短方案(202个周期)及拮抗剂方案(123个周期)治疗的患者,观察其胚胎发育、临床妊娠结局及并发症情况等。结果:长方案组与拮抗剂组的平均年龄[(32.75±4.45)和(33.97±5.09)岁]及基础FSH[(7.23±2.32)和(7.97±3.57)IU/L]均显著低于短方案组[(36.04±4.87)岁;(10.07±5.37)IU/L]。长方案组的平均获卵数最高(13.27±6.69),短方案组最低(7.72±5.23),各组间差异显著。3组的平均促性腺激素释放激素激动剂(GnRH-a)用量无显著差异[(2 587±919)和(2 652±1 131),(2 498±1 111)IU],但短方案组和拮抗剂组的平均Gn天数[(10.01±2.19)和(9.88±2.06)d]及卵巢过度刺激综合征(OHSS)发生率(1.49%,0)均显著低于长方案组[(10.79±1.62)d;6.68%]。胚胎发育方面,3组的受精率、卵裂率、两原核(2PN)受精率、2PN卵裂率和异常受精率均无显著差异。长方案组和拮抗剂组的可利用胚胎率(47.56%和48.75%)显著低于短方案组(56.77%)。妊娠结局方面,3组方案的临床妊娠率(44.03%,42.86%,39.29%)、生化妊娠率(12.50%,11.43%,3.57%)和胚胎种植率(28.46%,27.66%,25.81%)均无统计学差异(P>0.05)。结论:长方案、短方案和拮抗剂方案具有相似的妊娠结局,但后两者的OHSS发生率显著低于长方案。
Objective： To explore the effectiveness of different ovarian stimulation protocol in in vitro fertilization （IVF） outcome. Methods： The data from 924 IVF cycles, including long GnRH ago- nist （GnRH-a） protocol （599 cycles）, short GnRH agonist protocol （202 cycles） and GnRH an- tagonist （GnRH-ant） protocol （123 cycles） were collected in Beijing Chaoyang Hospital from Jan- uary 2013 to June 2015. The general information, embryonic development and clinical outcomes were compared among these three groups. Results： The average age and basic FSH level in short GnRH-a group,（36.04±4.87） years and （10. 07±5. 37） IU/L, were significantly higher than those of long GnRH-agroup and GnRH-ant group, （32.75±4.45） and （33.97±5.09） years;（7.23±2.32） and （7.97±3.57） IU/L, respectively. Dosage of Gn were similar in three groups as （2 587±919）, （2 652±1 131） and （2 498±1 111） IU, respectively, but differences in the du- ration of stimulation and OHSS rate were significant between long GnRH-a group as [10. 79±1.62） d, 6.68%] and the other two groups as （10.79±1. 62） vs （10. 01±2.19）, （9. 882±2.06） d and 6. 68% vs 1. 49%, 0, respectively. The numbers of oocytes were obviously different in three groups as （13.27±6.69）, （7. 72±5.23） , （10.35±6.38）, P〈0.05. Available embryo rate was significantly higher in short GnRH-a group （56. 77%） compared with the other two groups （47. 56% and 48. 75%）. There were no difference in clinical pregnancy rate （44.03%, 42.86% and 39.29%）, biochemical pregnancy rate （12.50%, 11.43%, and 3.57%） and implantation rate （28.46%, 27. 66%, and 25.81%） in three groups. Conclusion. Long GnRH-a protocol, short Gn- RH-a protocol and GnRH-ant protocol have similar pregnancy outcomes, hut short GnRH-a protocol and GnRH-ant protocol have lower OHSS rate as compared with long GnRH-a protocol.
出处
《武汉大学学报（医学版）》
CAS
2016年第2期254-257,共4页
Medical Journal of Wuhan University
基金
国家自然科学基金面上项目(编号:81270753
81471511)
北京市高层次卫生人才培养计划(编号:2013-3-021)
首都医科大学附属北京朝阳医院青年科学基金项目(编号:YQ2014-12)
