国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2018, Vol. 37 ›› Issue (1): 28-31.

• 论著 • 上一篇    下一篇

卵巢低反应者减量降调节并控制Gn启动剂量的体外受精结局

陈艳，周爱莲   

  1. 512026  广东省韶关市妇幼保健院生殖中心
  • 收稿日期:2017-09-06 修回日期:2018-01-04 出版日期:2018-01-15 发布日期:2018-02-02

The IVF Outcome of Reducing the Down-Regulation and Controlling the Gn Start Dose in Those Poor Ovarian Responders

CHEN Yan, ZHOU Ai-lian   

  1. Reproductive Center, Shaoguan Maternal and Child Health Care Hospital, Shaoguan 512026, Guangdong Province, China
  • Received:2017-09-06 Revised:2018-01-04 Published:2018-01-15 Online:2018-02-02

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摘要： 目的：探讨减量降调节并控制促性腺激素（Gn）启动剂量在卵巢低反应（POR）患者体外受精-胚胎移植（IVF-ET）中的应用效果。方法：本研究将2015年12月—2017年7月拟在广东省韶关市妇幼保健院生殖中心行IVF助孕的POR患者在黄体中期予1.0 mg促性腺激素释放激素激动剂（GnRHa）降调节后，随机分为A、B组，选择不同Gn启动剂量（A组Gn启动剂量150～225 IU，B组Gn启动剂量300～450 IU），对2组Gn总用量、Gn用药时间，人绒毛膜促性腺激素（hCG）注射日雌二醇（E2）水平、获卵数、受精率、优质胚胎数、可移植胚胎数、临床妊娠率等进行比较。结果：A组中获卵周期285个，B组中获卵周期292个，对获卵周期进行比较，A组较B组Gn用量减少（P＜0.05），Gn天数长（P＜0.05），hCG注射日E2水平低（P＜0.05），获卵数、受精率、优质胚胎数、可移植胚胎数差异均无统计学意义（P＞0.05）。A组临床妊娠率高于B组，差异有统计学意义（P＜0.05）。结论：POR患者应用长效长方案促排卵行IVF-ET助孕，减量降调节并控制Gn启动剂量，能够改善患者的助孕结局并降低患者的促排卵药物治疗费用。

关键词: 受精, 体外, 胚胎移植, 促性腺素释放激素, 卵巢低反应, 促性腺素类

Abstract: Objective：To investigate the outcome of reducing the dose of gonadotropin releasing hormone agonist (GnRHa) and controlling the dose of gonadotropins (Gn) starting in the long-down-regulation protocol for those poor ovarian response (POR) patients. Methods: The POR patients undergoing the long-down-regulation protocol with 1.0 mg GnRHa in our center from December 2015 to July 2017 were randomly divided into the group A and B. The Gn starting dose of the group A was 150-225 IU, and the Gn starting dose of the group B was 300-450 IU. Total dose of Gn, the days of Gn using, the estradiol (E2) level on the day of hCG injection, the number of retrieved oocytes, the fertilization rate, the number of excellent embryos, the number of transplantable embryos, and the clinical pregnancy rate were compared between the two groups. Results: There were 285 cycles of obtained-oocytes in the group A, while 292 cycles in the group B. The total dose of Gn and the E2 level on the day of hCG injection in the group A were significantly lower than those in the group B (P＜0.05), the total days of Gn using was significantly more than the group B (P＜0.05). There were no statistical differences in the number of obtained oocytes, the fertilization rate, the number of transplantable embryos and the number of excellent embryos between the two groups (all P＞0.05). Interestingly, the clinical pregnancy rate in the group A was statistically higher than that in the group B (P＜0.05). Conclusions: For those POR patients undergoing IVF-ET, reducing the dose of GnRHa and controlling the dose of gonadotropins startings in the long-down-regulation protocol can improve the IVF outcome and reduce their cost of ovulation drug treatment.

Key words: Fertilization in vitro, Embryo transfer, Gonadotropin-releasing hormone, Poor ovarian response, Gonadotropins