国际生殖健康/计划生育 ›› 2020, Vol. 39 ›› Issue (5): 361-364.

• 论著 • 上一篇    下一篇

拮抗剂方案不同扳机方式对卵母细胞成熟及妊娠结局的影响

魏超峰,连方   

  1. 250000  济南,山东中医药大学中医妇科学专业2018级硕士(魏超峰);山东中医药大学附属医院(连方)
  • 收稿日期:2020-03-27 修回日期:2020-04-28 出版日期:2020-09-15 发布日期:2020-09-11
  • 通讯作者: 连方,E-mail:f_lian@163.com E-mail:1358339556@qq.com
  • 基金资助:
    国家自然科学基金(81974577)

Effects of Different Triggering Patterns on Oocyte Maturation and Pregnancy Outcome during Antagonist Regimen

WEI Chao-feng, LIAN Fang   

  1. Shandong University of Traditional Chinese Medicine, Master of Gynecology of Traditional Chinese Medicine,Grade 2018,Jinan 250000,China(WEI Chao-feng);Hospital Affiliated to Shandong University of Traditional Chinese Medicine,Jinan 250000,China(LIAN Fang)
  • Received:2020-03-27 Revised:2020-04-28 Published:2020-09-15 Online:2020-09-11
  • Contact: LIAN Fang,E-mail:f_lian@163.com E-mail:1358339556@qq.com

摘要: 目的:比较拮抗剂方案不同扳机方式对卵母细胞成熟及妊娠结局的影响。方法:回顾性分析2014年1月—2018年12月于山东中医药大学附属医院生殖中心行体外受精-胚胎移植拮抗剂方案的患者数据,根据拮抗剂方案中的扳机方式分为2组。A组为促性腺激素释放激素激动剂(GnRHa)0.2 mg与人绒毛膜促性腺激素(hCG)2 000 IU板机,共58个取卵周期;B组为hCG 10 000 IU或重组人绒毛膜促性腺激素(rhCG,艾泽)250 μg或hCG 2 000 IU+艾泽250 μg扳机,共118个取卵周期。分析2组患者年龄、不孕时间,体质量指数(BMI)、基础卵泡刺激素(FSH)、促性腺激素(Gn)刺激天数、Gn用量、获卵数、成熟卵率、2PN受精率、第3天(D3)Ⅰ级胚胎率、生化妊娠率、临床妊娠率和活产率等。结果:2组患者年龄、不孕时间、BMI、基础FSH水平、Gn天数和Gn用量比较,差异均无统计学意义(P>0.05);2组患者成熟卵率、2PN受精率、生化妊娠率、异位妊娠率和流产率比较,差异无统计学意义(P>0.05);A组获卵数、D3 Ⅰ级胚胎率、临床妊娠率、活产率显著高于B组(P<0.05)。结论:拮抗剂方案中GnRHa联合hCG扳机与hCG单扳机比较可改善妊娠结局,尤其对于既往卵母细胞及胚胎质量差的患者,可尝试运用。

关键词: 体外受精;, 胚胎移植;, 不育, 女(雌)性;, 促性腺素释放激素;, 绒毛膜促性腺激素;, 妊娠结局

Abstract: Objective: To compare the effects of different triggering methods on the oocyte maturation and pregnancy outcome during antagonist regimen. Methods: A retrospective analysis was performed on the data of patients who underwent in vitro fertilization-embryo transfer (IVF-ET) antagonist protocol in our center from January 2014 to December 2018. A total of 176 cycles were divided into 2 groups according to the trigger method. Group A (dual trigger) was treated with gonadotropin-releasing hormone agonist (GnRHa) 0.2 mg and human chorionic-gonadotropin (hCG) 2 000 IU(n=58), and Group B (single trigger) was treated with hCG 10 000 IU, rhCG 250 μg or hCG 2 000 IU+rhCG 250 μg (n=118) . The age, infertility time, body mass index (BMI), basal follicular stimulating hormone (FSH), gonadotropin (Gn) stimulation days, Gn dosage, number of retrieved oocytes, mature oocytes rate, 2PN fertilization rate, D3I embryo rate, biochemical pregnancy rate, clinical pregnancy rate and live birth rate were analyzed. Results: There were no significant differences in the age, infertility time, BMI, basal FSH level, Gn days and Gn dosage between the two groups (P>0.05). There were no significant differences in the mature oocytes rate, 2PN fertilization rate, biochemical pregnancy rate, ectopic pregnancy rate and abortion rate between the two groups (P>0.05). However, the number of retrieved oocytes, D3I embryo rate , clinical pregnancy rate and live birth rate in Group A were significantly higher than those in Group B (all P<0.05). Conclusions: Compared with hCG trigger alone in antagonist regimen, the GnRHa combined with hCG trigger method can improve the pregnancy outcome. Especially, those patients with poor oocyte and embryo quality may try the combined trigger method. 

Key words: Fertilization in vitro;, Embryo transfer;, Infertility, female;, Gonadotropin-releasing hormone;, Chorionic gonadotropin;, Pregnancy outcome