摘要
目的:探讨子宫内膜异位症合并不孕患者体外受精(IVF)治疗采用不同促排卵方案的妊娠结局,探讨子宫内膜异位症患者助孕的促排卵方案。方法:选择2003年1月至2018年1月期间因子宫内膜异位症合并不孕行IVF治疗患者(297周期),根据促排卵方案不同分为长方案组(长效长方案、卵泡期长方案)、改良超长方案组、超长方案组和非降调方案组(拮抗剂方案),比较不同方案的临床、实验室指标及随访结局分析。结果:各组年龄、体质量指数(BMI)、基础促卵泡激素、不孕年限、原发不孕率、获卵数、不同方案在AFS分期中所占周期数差异均无统计学意义(P>0.05)。各组MⅡ卵数差异有统计学意义(P<0.05),长方案组MⅡ卵数最多;但4组的2PN数、优胚数、冷冻胚胎数、移植胚胎数、种植率、妊娠率、流产率、活产率差异无统计学意义(P>0.05)。各组Gn量、hCG日内膜厚度差异有统计学意义(P<0.05),改良超长方案Gn量最多,非降调方案量最少,非降调方案hCG日子宫内膜最薄(P<0.05)。各组因卵巢低反应放弃周期率,差异无统计学意义(P>0.05)。结论:子宫内膜异位症患者促排卵可以有很多方案选择,均可获得与超长方案相似的结局,非降调方案还能减少促排药物的用量。
Objective:To explore the pregnancy outcome of the patients with endometriosis and infertility treated by in vitro fertilization(IVF)with different strategies of ovulation induction and to probe the best ovulation induction strategy for endometriosis patients to pregnancy.Methods:The patientswith endometriosis and infertility treated by IVF(297 cycles)in the reproductive center of Qinghai Province Hospital between 2003 and 2018 were included in this retrospective study.According to the different ovulation induction strategies,the patients were divided into four groups:Long protocol group(prolongedlong protocol group,follicle long protocol group),modified ultra-long protocol group,ultra-long protocol group,and non-downregulation protocolgroup(antagonist protocol).The clinical and laboratory indexes as well as follow-up results of different strategies were compared.Results:There was no significant difference in age,body mass index,basic follicle stimulating hormone(bFSH),infertility years,primary infertility rate,number of retrieved oocytes and the number of IVF cycles of different protocols in AFS stagein each group(P>0.05).There were significant differences in the number of retrieved oocytes and the number of MⅡoocytes in each group(P<0.05).The number of MⅡoocytes in long protocol were the largest.But there was no significant difference in the number of 2 PN,excellent embryo,cryopreservationembryo,transferred embryo,implantation rate,pregnancy rate,early abortion rate and live birth rate among the four groups(P>0.05).There were statistically significant differences in the dosage of Gn and the endometrial thickness inhCGinjection day in each group(P<0.05).The dosage of Gn in the modified ultra-longprotocol was the most,in the non-downregulation protocol was the least,and the endometrial thickness in the non-downregulation protocol was the thinnest.There was no significant difference in the rate ofcycle cancellation due to low ovarian responsein each group(P>0.05).Conclusions:There are manyovulation induction strategies for the patients with endometriosis,which can achieve similar outcomes as the long protocol,and the non-downregulationprotocol can decrease the dosage of ovulation induction medicine.
作者
曾湘晖
王莉云
纪冰
ZENG Xianghui;WANG Liyun;JI Bing(Reproduction Center of Qinghai Provincial People's Hospital,Xining Qinghai 810001,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2020年第2期145-148,共4页
Journal of Practical Obstetrics and Gynecology
