摘要
目的研究不同剂量促性腺激素释放激素拮抗剂(GnRH-ant)对卵巢储备功能正常的IVF/ICSI-ET患者临床结局的影响。方法回顾性分析2016年1月至2017年4月行IVF/ICSI-ET助孕的600例卵巢储备功能正常的患者的临床资料。其中GnRH激动剂(GnRH-a)长方案组200例,GnRH-ant 0. 125 mg组(半量组) 200例,GnRH-ant0. 25 mg组(全量组) 200例,对3组患者临床和实验室资料进行比较。结果半量组添加拮抗剂时血黄体生成素(LH)水平显著低于全量组,其所需的拮抗剂剂量也显著减少。两拮抗剂组ICSI卵子成熟率高于激动剂长方案组,OHSS发生率低于激动剂长方案组。3组间早熟的LH峰发生率相当,临床妊娠率和活产率无差异。结论在卵巢储备功能正常的患者中应用拮抗剂方案可以提高ICSI卵子成熟率并降低OHSS发生的风险,但对临床结局无影响,可以作为卵巢功能正常患者的一个很好的促排卵选择,0. 125 mg和0. 25 mg拮抗剂组临床结局无差异,在适宜的患者中应用半量拮抗剂方案可以在保证治疗效果的前提下为患者减轻经济负担。
Objective To investigate the effects of different doses of gonadotropin releasing hormone antagonist(GnRH-ant)on clinical outcomes of patients undergoing in vitro fertilization and embryo transfer(IVF-ET)with normal ovarian reservation function.Methods The clinical data about 6,000 patients with normal ovarian reservation function who underwent IVF/ICSI-ET in our hospital from January 2016 to April 2017 were retrospectively analyzed.These patients were divided into three groups:GnRH long protocol group(n=200),GnRH-ant semi-dose group(0.125mg,n=200)and GnRH-ant full dose group(0.25mg,n=200).The clinilal data and experimental data were compared among the three groups.Results The LH levels in GnRH-ant semi-dose group were significantly lower than those in GnRH-ant full dose group,moreover the dosage of GnRH-ant needed in GnRH-ant semi-dose group was also significantly decreased.The oocyte maturation rates in GnRH-ant semi-dose group and GnRH-ant full dose group were higher than those in GnRH-ant long protocol group,moreover the incidences of ovarian hyper-stimulus syndrome(OHSS)were lower than that in GnRH agonist long protocol group.There were no significant differences in the incidence of premature LH peak,clinical pregnancy rate and live birth rate among the three groups.Conclusion The application of GnRH-ant protocol in patients with normal ovarian reservation function can increase the maturation rate of ICSI oocytes and reduce the risk of incidence of OHSS,but which has no effects on clinical outcomes,thus,which can be regarded as a good choice of ovarian stimulation for patients with normal ovary function.In addition there is no significant difference in the clinical outcomes between 0.125mg GnRH-ant group and 0.25 mg GnRH-ant group,therefor,the application of a half dose antagonist regimen in appropriate patients can reduce the economic burden while ensuring good clinical curative effects.
作者
张杰
王少卿
许月明
郝桂敏
ZHANG Jie;WANG Shaoqing;XU Yueming(Department of Reproductive Medicine,The Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)
出处
《河北医药》
CAS
2018年第23期3530-3534,共5页
Hebei Medical Journal
关键词
促性腺激素释放激素拮抗剂
体外受精-胚胎移植
卵巢过度刺激综合征
gonadotropin releasing hormone antagonist
in vitro fertilization and embryo transfer
ovarian hyperstimulation syndrome
ovarian hyper-stimulus syndrome
