摘要
目的:探讨添加生长激素(GH)在卵巢储备功能减退(DOR)患者供精人工授精(AID)治疗中的作用。方法:回顾性分析2020年1月-2023年12月在本中心接受≥3次AID治疗失败后添加生长激素辅助治疗的DOR患者66例临床资料,比较患者GH添加周期与未添加周期时AID周期临床资料及其妊娠结局。结果:患者GH添加周期时年龄、不孕年限及既往AID失败周期数高于未添加周期时,而窦卵泡数、AMH水平低于未添加周期时(均P<0.05);GH添加周期及未添加周期时患者基础FSH水平、HCG日优势卵泡数、HCG日优势卵泡直径、HCG日子宫内膜厚度均无差异(P>0.05);GH添加周期时患者HCG日A型子宫内膜占比(65.2%)、临床妊娠率(24.2%)、活产率(21.2%)均高于未添加周期时(43.9%、4.6%、0)(均P<0.05),流产率GH添加周期时(12.5%)低于未添加周期时(100%)(P<0.001),生化妊娠率无差异(1.5%比3.0%,P>0.05)。广义估计方程模型表明,在校正年龄、不孕年限、既往AID失败周期数等影响因素后,只有添加GH与临床妊娠率增加显著相关(OR=19.420,95%CI 3.886~97.050,P=0.000)。结论:添加生长激素可以改善卵巢功能减退患者供精人工授精的妊娠结局。
Objective:To investigate the role of the growth hormone(GH)in the treatment of patients with diminished ovarian reserve(DOR)undergoing artificial insemination with donor semen(AID).Methods:A retrospective analysis was carried out on the clinical data of 66 patients with DOR who failed three or more previous AID cycles and the subsequent cycle received the GH adjuvant therapy in the hospital from January 2020 to December 2023.The clinical data and the pregnancy outcomes of the patients were compared between the AID cycle with GH adjuvant therapy and the AID cycle without GH adjuvant therapy.Results:The age,the duration of infertility and the number of previous failed AID cycles of the patients in the AID cycle with GH adjuvant therapy were significantly higher than those of the patients in the AID cycle without GH adjuvant therapy,and the number of the antral follicles(AFC)and the AMH level of the patients in the AID cycle with GH adjuvant therapy were significantly lower(all P<0.05).There were no significant differences in the baseline FSH level,the number and the diameter of the dominant follicles on the day of HCG administration,and the endometrial thickness on the day of HCG administration of the patients between the AID cycle with GH adjuvant therapy and the AID cycle without GH adjuvant therapy(P>0.05).The proportions of the type A endometrium on the day of HCG administration(65.2%),the clinical pregnancy rate(24.2%)and the live birth rate(21.2%)of the patients in the AID cycle with GH adjuvant therapy were significantly higher than those(43.9%,4.6%and 0)of the patients in the AID cycle without GH adjuvant therapy(all P<0.05).The miscarriage rate(12.5%)of the patients in the AID cycle with GH adjuvant therapy was significantly lower than that(100%)of the patients in the AID cycle without GH adjuvant therapy.There was no significant difference in the biochemical pregnancy rate(1.5%vs.3.0%)of the patients between the AID cycle with GH adjuvant therapy and the AID cycle without GH adjuvant therapy(P>0.05).The generalized estimating equation model indicated that the GH adjuvant therapy for the patients was significantly associated with their increased clinical pregnancy rate after adjusting for the influence factors,such as the age,the duration of infertility and the number of the previous failed AID cycles.Conclusion:The addition of GH for adjuvant therapy in AID for the patients with DOR can improve their pregnancy outcomes.
作者
张蔚
耿琳琳
张广志
郭永
周宝琳
陈娟
ZHANG Wei;GENG Linlin;ZHANG Guangzhi;GUO Yong;ZHOU Baolin;CHEN Juan(National Research Institutefor Family Planning,Beijing,100081)
出处
《中国计划生育学杂志》
2025年第6期1375-1380,共6页
Chinese Journal of Family Planning
基金
中央级公益性科研院所基本科研业务费专项(2022GJZD0102)。
关键词
供精人工授精
卵巢储备功能减退
添加生长激素
妊娠结局
Artificial insemination with donor semen
Diminished ovarian reserve
Addition of growth hormone
Pregnancy outcomes
