国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2012, Vol. 31 ›› Issue (5): 393-396.

• 论著 • 上一篇    下一篇

控制性超排卵间断停药方案的评价与启发

高明霞,陈思同,马晓玲,张学红,刘琨   

  1. 730000 兰州大学第一医院生殖医学专科医院（高明霞，马晓玲，张学红，刘琨）；重庆医科大学临床医学院（陈思同）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-09-15 发布日期:2012-09-15
  • 通讯作者: 张学红

Evaluation for the Intermittent Withdrawal Protocol in COH

GAO Ming-xia，CHEN Si-tong，MA Xiao-ling，ZHANG Xue -hong，LIU Kun   

  1. Reproductive Medical Hospital，the First Hospital of Lanzhou University，Lanzhou 730000，China（GAO Ming-xia，MA Xiao-ling，ZHANG Xue-hong，LIU Kun）；Clinical Medical Collegeof Chongqing Medical University，Chongqing 400016，China（CHEN Si-tong）
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-09-15 Online:2012-09-15
  • Contact: ZHANG Xue -hong

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摘要： 目的：探讨控制性超排卵（COH）间断停药方案对卵巢高反应及慢反应患者体外受精-胚胎移植（IVF-ET ）结局的影响。方法：回顾性分析2009 年9月—2011 年2月于兰州大学第一医院生殖医学专科医院进行IVF-ET 的223 例卵巢高反应及慢反应患者资料，根据COH 过程是否间断停药分为2组，比较2组的胚胎质量、妊娠结局、卵巢过度刺激综合征（OHSS）的发生率等。结果：间断停药组的基础雌二醇（E2）、COH 第3天及第7天E2、COH 第7天黄体生成激素（LH）高于未停药组，差异有统计学意义（P＜0.01）；间断停药组移植日子宫内膜厚度大于未停药组，差异有统计学意义（P＜0.05）；2组受精率、卵母细胞第二次减数分裂中期细胞率、双原核细胞率、优质胚胎率、临床妊娠率、流产率差异均无统计学意义（P＞0.05）；间断停药组为OHSS 高风险组，经使用间断停药方案后其中重度OHSS 发生率与未停药组相比差异无统计学意义（P＞0.05）。结论：COH间断停药方案在高反应及慢反应的病例中不影响成熟卵母细胞的获取、胚胎质量及妊娠率，减少了因OHSS 高风险或未获得卵子而发生的周期取消数，减慢了子宫内膜的发育速度，使胚胎与内膜之间获得了更好的同步化发育。

关键词: 卵巢, 排卵诱导, 临床方案, 受精, 体外, 胚胎移植, 卵母细胞抽取, 妊娠率

Abstract: Objective：To evaluate the protocol of intermittent withdrawal in controlled ovarian hyperstimulation （COH）in high -responders and slow-responders. Methods 院Total 223 high-responders and slow -responders in IVF-ET circles, reviewed from Sep.2009 to Feb.2011, were divided into two groups: 110patients with the intermittent withdrawal protocol and 113 patients without intermittent withdrawal. Embryonicquality，OHSS's incidence，pregnancy rate，and miscarried rate of two groups were compared. Results 院There were significant difference in basalE2，serumE2 on the third and seventh day，serum LH on the seventh day between with and without the intermittent withdrawal protocol group（P＜0.01）. No significant difference（P＞0.05）was found in fertilization，M域ova，2PN，good quality embryos，pregnancy and miscarried rate between two groups，nor the incidence of moderate severe OHSS in high risk patients. Conclusions 院Although the intermittent withdrawalprotocolinhigh-resorponders and slow-responders does not affect the ovular quality and embryonicquality, it reduces the cycle cancellation caused by obtaining no egg or high risk of OHSS，slows down the speed of endometrial development，and gets a better synchronization between endometrim and embryo.

Key words: Ovary, Ovulation induction, Clinical protocols, Fertilization in vitro, Embryo transfer, Oocyte retrieval, Pregnancy rate