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): 388-392.

• 论著 • 上一篇    下一篇

高龄妇女降调节方案中补充人基因重组黄体生成激素对卵巢反应性及着床率的影响

叶虹,黄国宁,裴莉,曾品鸿,张孝东,罗秀   

  1. 400013 重庆市妇产科医院遗传与生殖研究所
  • 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: 叶虹

Effects of the Supplemental Recombinant Human Luteinizing Hormone on the Ovarian Stimulation andImplantation Rate in Those Down-regulated Women of Advanced Reproductive Age

YE Hong，HUANGGuo -ning，PEI Li，ZENG Pin -hong，ZHANG Xiao -dong，LUO Xiu   

  1. Chongqing Genetic and ReproductiveInstitute，Chongqing Obstetrics and Gynecology Hospital，Chongqing 400013，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-09-15 Online:2012-09-15
  • Contact: YE Hong

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摘要： 目的：研究中国高龄妇女常用促性腺激素释放激素激动剂（GnRHa）长方案补充人基因重组黄体生成激素（rLH）的有效性。方法：选择2010 年3月—2011 年11月收治的接受体外受精/胞浆内单精子注射（IVF/ICSI）助孕的320 个周期，进行同期前瞻随机开放对照临床试验。所有受试者均具有正常促性腺功能，年龄35耀40岁，且均为首次接受IVF/ICSI 助孕的不孕女性。采用黄体期曲普瑞林（Triptorelin）0.05 mg/d 长方案。从人基因重组卵泡刺激素（rFSH）启动日开始按计算机分配的序号随机分为5组：淤对照组（C组，n= 61）仅用rFSH 促排卵。于T1组（n=63）rFSH 促排卵第6天（D6）开始补充rLH 75 IU/d 至人绒毛膜促性腺激素（hCG）：注射日。盂T2组（n=65）：D6开始补：充rLH 150 IU/d 至hCG 注射日。榆T3组（n=68）：rFSH 促排卵第1天（D1）开始补充rLH 75 IU/d 至hCG 注射日。虞T4组（n=63）：D1开始补充rLH 150 IU/d 至hCG 注射日。rFSH 启动剂量均为225 IU/d，共5d，然后根据卵巢反应调整剂量。结果：无论rLH 补充的时间、剂量的不同以及是否补充rLH，控制性卵巢刺激（COS）后的获卵数、获成熟卵数、受精率、着床率及妊娠结局差异均无统计学意义（P＞0.05）。结论：补充rLH 对正常促性腺功能的高龄妇女无明显益处，因此，排卵功能正常的高龄妇女COS
采用Triptorelin 0.05 mg/d 降调节方案时，rLH 补充并非必需。

关键词: 促黄体素, 受精, 体外, 卵泡刺激素, 人, 控制性促排卵, 不孕, 女（雌）性, 年龄因素, 妊娠结局

Abstract: Objective：To evaluate the effects of recombinant human luteinizing hormone （rLH）supplementation on the ovarian stimulation and implantation rate in those down -regulated Chinese women ofadvanced reproductive age. Methods :This isa prospective randomized controlled trial. 320 cycles of ART wereanalyzed. All infertile patients with consecutive normogonadotropic function, aged 35-40 years, underwent theirfirst IVF or intracytoplasmic sperm injection （ICSI）treatment cycle. After pituitary suppression with Triptorelinacetate 0.05 mg/d s.c started in the midluteal phase of the previous cycle，the patients were randomized dividedinto five groups：淤control group（n=61）：only received rFSH for ovarian stimulation until day of hCG injection.于T1 （n=63）：rLH 75 IU/d supplementation on day6 of rFSH stimulation until day of hCG injection. 盂T2 （n=65）：rLH 150 IU/d supplementation on day 6 of rFSH stimulation until day of hCG injection. 榆T3 （n=68）：rLH75 IU/d supplementation on day 1 of rFSH stimulation until day of hCG injection. 虞T4 （n=63）：rLH 150 IU/dsupplementation on day1 of rFSH stimulation until day of hCG injection. Ovarian stimulation was initiated withrFSH 225 IU/d, 5 days in all of groups. Results 院No significant differences were observed in terms of numberand maturity of oocytes，fertilized oocytes，implantation rate and pregnancy rate among groups （P ＞0.05）.Conclusions 院The rLH supplementation with daily doses 75 or 150 IU during early follicular phase or secondhalf follicular phase dose not improve ovarian response and implantation rates in those normogonadotropicwomen of advanced reproductive age who were stimulated with rFSH under pituitary suppression with Iriptorelinacetate 0.05 mg/d s.c for IVF，therefore the rLH supplementation is not needed in all down regulated women ofadvanced reproductive age.

Key words: Luteinizing hormone, Fertilization in vitro, Follicle stimulating hormone, human, Controlledovarian stimulation, Infertility, female, Age factors, Pregnancy outcome