Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo tra...Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 341 IVF-ET cycles were retrospectively identified. The following inclusion criteria were applied: age ≥ 40 years and patients with tubal factors. The cycles were divided into two groups: a GnRH antagonist group (157 cycles) and a GnRH agonist group (184 cycles). Results: The duration of stimulation and the total doses of gonadotropin in the GnRH agonist group were significantly more than those in the GnRH antagonist group (P < 0.05). There were significant differences in LH and P values on the hCG measurement days between the two groups (0.91 ± 1.17 vs. 4.82 ± 4.69 U/L and 0.69 ± 0.42 vs. 1.03 ± 0.50 ng/mL, P < 0.05). The implantation rate of the GnRH antagonist group was 12.24%, which was slightly higher than that of the GnRH agonist group (10.10%, P = 0.437). The clinical pregnancy rate of the two groups showed no statistical differences (23.36% vs. 23.03%, P = 1.000). Conclusion: For expected poor ovarian responders, the GnRH antagonist protocol was, to some extent, superior to the GnRH agonist protocol in terms of the implantation and clinical pregnancy rates.展开更多
目的比较卵巢低反应(POR)患者行促性腺激素释放激素拮抗剂(GnRH-ant)及GnRH激动剂(GnRH-a)短方案的临床疗效。方法计算机检索PubMed、ProQuest Medical Library、Medline外文生物医学期刊文献数据库、中国生物医学文献数据库(CBM)、中...目的比较卵巢低反应(POR)患者行促性腺激素释放激素拮抗剂(GnRH-ant)及GnRH激动剂(GnRH-a)短方案的临床疗效。方法计算机检索PubMed、ProQuest Medical Library、Medline外文生物医学期刊文献数据库、中国生物医学文献数据库(CBM)、中国知网(CNKI)、中国科技期刊数据库(VIP)、万方数据库和读秀学术搜索引擎等。收集2000年至2014年10月发表的相关文献,比较POR患者行GnRH-ant及GnRH-a短方案的临床试验,按Cochrane系统评价方法提取有效数据,采用RevMan 5.2软件进行Meta分析。结果共纳入11篇文献,共855例(1 054个周期)POR患者,其中GnRHant组444例(549个周期),GnRH-a短方案组411例(505个周期);Meta分析结果显示:对于POR患者,两组间临床妊娠率[RR=1.25,95%CI(0.96,1.63),P=0.10]、促性腺激素(Gn)时间[WMD=-1.15,95%CI(-2.56,0.25),P=0.11]、Gn用量[WMD=63.54,95%CI(-59.08,186.17),P=0.31]、获卵数[WMD=0.16,95%CI(-0.66,0.98),P=0.70]、周期取消率[RR=1.07,95%CI(0.85,1.35),P=0.57]差异均无统计学意义,但临床妊娠率的结果偏向于拮抗剂组更优。结论对于POR患者,拮抗剂方案和GnRH-a短方案效果无统计学差异,但是拮抗剂组可能更有助于提高临床妊娠率,可以作为POR患者助孕的一个选择。展开更多
目的：比较高龄不孕女性体外受精／卵胞质内单精子显微注射一胚胎移植（IVF／ICSI-ET）中微量短效GnRH-a长方案及常规短方案的促排卵效果及临床结局。方法：回顾性分析602例≥35岁不孕患者682个周期IVF／ICSI-ET临床结局，按促排卵方案...目的：比较高龄不孕女性体外受精／卵胞质内单精子显微注射一胚胎移植（IVF／ICSI-ET）中微量短效GnRH-a长方案及常规短方案的促排卵效果及临床结局。方法：回顾性分析602例≥35岁不孕患者682个周期IVF／ICSI-ET临床结局，按促排卵方案分为微量短效GnRH-a长方案组（172个周期，A组）和常规短方案组（510个周期，B组），再以年龄段分层（35～37岁，38～39岁及≥40岁），分别比较不同年龄段两种促排卵方案的效果及临床结局。结果：A组Gn用量、Gn使用天数显著高于B组（P〈0．05），MⅡ卵数、优质胚胎率、胚胎移植数、周期取消率均无统计学差异（P〉0．05）；A组与B组相比，临床妊娠率、活产率（36．1％坩29．8％；28．5％vs 23．3％；P〉0．05）有改善趋势；尤其在35～37岁及38～39岁患者中，A组优质胚胎率、临床妊娠率、活产率（52．89％vs 47．16％，50．14％ vs 47．97％；41．7％ vs 36．7％，36．4％ vs 22．2％；35．0％ vs 29．2％，24．2％ vs 15．7％；P均〉0．05）均有明显改善趋势。结论：≥35岁不孕女性微量GnRH-a长方案临床结局有改善趋势，可作为高龄不孕女性，尤其是35～39岁不孕患者的有效促排卵方案之一。展开更多
文摘Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 341 IVF-ET cycles were retrospectively identified. The following inclusion criteria were applied: age ≥ 40 years and patients with tubal factors. The cycles were divided into two groups: a GnRH antagonist group (157 cycles) and a GnRH agonist group (184 cycles). Results: The duration of stimulation and the total doses of gonadotropin in the GnRH agonist group were significantly more than those in the GnRH antagonist group (P < 0.05). There were significant differences in LH and P values on the hCG measurement days between the two groups (0.91 ± 1.17 vs. 4.82 ± 4.69 U/L and 0.69 ± 0.42 vs. 1.03 ± 0.50 ng/mL, P < 0.05). The implantation rate of the GnRH antagonist group was 12.24%, which was slightly higher than that of the GnRH agonist group (10.10%, P = 0.437). The clinical pregnancy rate of the two groups showed no statistical differences (23.36% vs. 23.03%, P = 1.000). Conclusion: For expected poor ovarian responders, the GnRH antagonist protocol was, to some extent, superior to the GnRH agonist protocol in terms of the implantation and clinical pregnancy rates.
文摘目的比较卵巢低反应(POR)患者行促性腺激素释放激素拮抗剂(GnRH-ant)及GnRH激动剂(GnRH-a)短方案的临床疗效。方法计算机检索PubMed、ProQuest Medical Library、Medline外文生物医学期刊文献数据库、中国生物医学文献数据库(CBM)、中国知网(CNKI)、中国科技期刊数据库(VIP)、万方数据库和读秀学术搜索引擎等。收集2000年至2014年10月发表的相关文献,比较POR患者行GnRH-ant及GnRH-a短方案的临床试验,按Cochrane系统评价方法提取有效数据,采用RevMan 5.2软件进行Meta分析。结果共纳入11篇文献,共855例(1 054个周期)POR患者,其中GnRHant组444例(549个周期),GnRH-a短方案组411例(505个周期);Meta分析结果显示:对于POR患者,两组间临床妊娠率[RR=1.25,95%CI(0.96,1.63),P=0.10]、促性腺激素(Gn)时间[WMD=-1.15,95%CI(-2.56,0.25),P=0.11]、Gn用量[WMD=63.54,95%CI(-59.08,186.17),P=0.31]、获卵数[WMD=0.16,95%CI(-0.66,0.98),P=0.70]、周期取消率[RR=1.07,95%CI(0.85,1.35),P=0.57]差异均无统计学意义,但临床妊娠率的结果偏向于拮抗剂组更优。结论对于POR患者,拮抗剂方案和GnRH-a短方案效果无统计学差异,但是拮抗剂组可能更有助于提高临床妊娠率,可以作为POR患者助孕的一个选择。
文摘目的：比较高龄不孕女性体外受精／卵胞质内单精子显微注射一胚胎移植（IVF／ICSI-ET）中微量短效GnRH-a长方案及常规短方案的促排卵效果及临床结局。方法：回顾性分析602例≥35岁不孕患者682个周期IVF／ICSI-ET临床结局，按促排卵方案分为微量短效GnRH-a长方案组（172个周期，A组）和常规短方案组（510个周期，B组），再以年龄段分层（35～37岁，38～39岁及≥40岁），分别比较不同年龄段两种促排卵方案的效果及临床结局。结果：A组Gn用量、Gn使用天数显著高于B组（P〈0．05），MⅡ卵数、优质胚胎率、胚胎移植数、周期取消率均无统计学差异（P〉0．05）；A组与B组相比，临床妊娠率、活产率（36．1％坩29．8％；28．5％vs 23．3％；P〉0．05）有改善趋势；尤其在35～37岁及38～39岁患者中，A组优质胚胎率、临床妊娠率、活产率（52．89％vs 47．16％，50．14％ vs 47．97％；41．7％ vs 36．7％，36．4％ vs 22．2％；35．0％ vs 29．2％，24．2％ vs 15．7％；P均〉0．05）均有明显改善趋势。结论：≥35岁不孕女性微量GnRH-a长方案临床结局有改善趋势，可作为高龄不孕女性，尤其是35～39岁不孕患者的有效促排卵方案之一。
