[1]刘曼曼,管一春,刘文霞,等.不同促排卵方案对卵巢储备功能减退患者体外受精-胚胎移植结局的影响[J].新乡医学院学报,2019,36(6):529-532.[doi:10.7683/xxyxyxb.2019.06.007]
 LIU Man-man,GUAN Yi-chun,LIU Wen-xia,et al.Effect of different ovarian stimulation methods on the outcome of in vitro fertilization-embryo transfer in patients with ovarian reserve dysfunction[J].Journal of Xinxiang Medical University,2019,36(6):529-532.[doi:10.7683/xxyxyxb.2019.06.007]
点击复制

不同促排卵方案对卵巢储备功能减退患者体外受精-胚胎移植结局的影响
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年6
页码:
529-532
栏目:
临床研究
出版日期:
2019-06-05

文章信息/Info

Title:
Effect of different ovarian stimulation methods on the outcome of in vitro fertilization-embryo transfer in patients with ovarian reserve dysfunction
作者:
刘曼曼管一春刘文霞杜明泽刘朝朝李俊敏王兴玲
(郑州大学第三附属医院生殖医学科,河南 郑州 450052)
Author(s):
LIU Man-manGUAN Yi-chunLIU Wen-xiaDU Ming-zeLIU Zhao-zhaoLI Jun-minWANG Xing-ling
(Department of Reproductive Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)
关键词:
卵巢储备功能减退体外受精-胚胎移植促性腺激素释放激素激动剂促性腺激素释放激素拮抗剂妊娠结局
Keywords:
ovarian reserve dysfunctionin vitro fertilization-embryo transfergonadotropin releasing hormone agonistgonadotropin-releasing hormone antagonistpregnancy outcome
分类号:
R246.3
DOI:
10.7683/xxyxyxb.2019.06.007
文献标志码:
A
摘要:
目的 探讨不同促排卵方案对卵巢储备功能减退患者体外受精-胚胎移植(IVF-ET)结局的影响。方法 回顾性分析2016年1月至2017年12月于郑州大学第三附属医院进行IVF-ET助孕的150例卵巢储备功能减退患者的临床资料,其中采用促性腺激素释放激素激动剂(GnRHa)长方案促排卵者79例(GnRHa组),采用促性腺激素释放激素拮抗剂(GnRHant)方案促排卵者71例(GnRHant组),对2组不同年龄及不同卵巢反应性患者的窦卵泡计数(AFC)、基础卵泡刺激素 (bFSH)、人绒毛膜促性腺激素(HCG)注射日子宫内膜厚度、胚胎着床率、临床妊娠率及早期流产率进行比较。结果 2组年龄<35岁患者的AFC、血清bFSH水平、胚胎着床率及早期流产率比较差异无统计学意义(P>0.05),GnRHa组年龄<35岁患者的子宫内膜厚度及临床妊娠率大于GnRHant组(P<0.05)。2组年龄≥35岁患者的AFC、血清bFSH水平、子宫内膜厚度及早期流产率比较差异无统计学意义(P>0.05),GnRHa组年龄≥35岁患者的胚胎着床率及临床妊娠率高于GnRHant组(P<0.05)。2组卵巢低反应性和高反应性者的子宫内膜厚度、胚胎着床率、临床妊娠率及早期流产率比较差异无统计学意义(P>0.05),2组卵巢正常反应性患者的胚胎着床率及早期流产率比较差异无统计学意义(P>0.05),GnRHa组卵巢正常反应性患者的子宫内膜厚度和临床妊娠率高于GnRHant组(P<0.05)。结论 使用GnRHa长方案治疗卵巢储备功能减退患者的胚胎着床率和临床妊娠率更高;卵巢正常反应性的卵巢储备功能减退患者采用GnRHa长方案促排卵效果更好,卵巢高反应性和低反应性的卵巢储备功能减退患者采用GnRHa长方案与GnRHant方案促排卵的效果相当。
Abstract:
Objective To investigate the effect of different ovarian stimulation methods on the outcome of in vitro fertilization-embryo transfer (IVF-ET) in patients with ovarian reserve dysfunction.Methods The clinical data of 150 cases of ovarian reserve dysfunction treated with IVF-ET in the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2017 were retrospectively analyzed.Seventy-nine cases were treated with gonadotropin-releasing hormone agonist(GnRHa) long protocol (GnRHa group),71 cases were treated with gonadotropin-releasing hormone antagonist(GnRHant) (GnRHant group).The sinus follicle count (AFC),basal follicle stimulating hormone (bFSH),endometrial thickness on the day of human chorionic gonadotrophin(HCG) injection,embryo implantation rate,clinical pregnancy rate and early abortion rate of patients with different age and ovarian reactivity were compared between the two groups.Results There was no significant difference in AFC,serum bFSH level,embryo implantation rate and early abortion rate of patients aged <35 years between the two groups (P>0.05).The endometrial thickness and clinical pregnancy rate of patients aged <35 years in the GnRHa group were greater than those in the GnRHant group (P<0.05).There was no significant difference in AFC,serum bFSH level,endometrial thickness and early abortion rate of patients aged ≥ 35 years between the two groups (P>0.05).The embryo implantation rate and clinical pregnancy rate of patients aged ≥35 years in the GnRHa group were higher than those in the GnRHant group (P<0.05).There was no significant difference in endometrial thickness,embryo implantation rate,clinical pregnancy rate and early abortion rate of patients with ovarian hyporesponsiveness and hyperresponsiveness between the two groups (P>0.05).There was no significant difference in embryo implantation rate and early abortion rate of patients with normal ovarian responsiveness between the two groups (P>0.05).The endometrial thickness and clinical pregnancy rate of patients with normal ovarian responsiveness in the GnRHa group were higher than those in the GnRHant group (P<0.05).Conclusion The GnRHa long protocol on ovarian reserve dysfunction has higher embryo implantation rate and clinical pregnancy rate.The effect of GnRHa long protocol on ovarian stimulation is better in ovarian reserve dysfunction patients with normal ovarian responsiveness.The effect of GnRHa long protocol and GnRHant protocol on ovarian stimulation in ovarian reserve dysfunction patients with ovarian hyperresponsiveness and hyporesponsiveness is similar.

参考文献/References:

[1] 杨会生,房繄恭,李晓彤,等.针灸对体外受精-胚胎移植患者妊娠结局影响的随机对照试验系统评价[J].中华中医药杂志,2017,32(12):5591-5598.
[2] 郭莹,杨娜,蒋向荣,等.IVF-ET中不同年龄卵巢储备功能减退女性应用生长激素的效果分析[J].中国计划生育学杂志,2017,25(11):760-763.
[3] 中华医学会妇产科学分会产科学组.孕前和孕期保健指南:第1版[J].中华妇产科杂志,2011,46(2):150-153.
[4] ZHAO X,MA B,MO S,et al.Improvement of pregnancy outcome by extending embryo culture in IVF-ET during clinical application[J].J Assist Reprod Genet,2018,35(2):321-329.
[5] 孙雪,桑敏,孙晓妍,等.中医药协同体外受精-胚胎移植技术治疗多囊卵巢综合征所致不孕症[J].中医学报,2017,32(1):106-109.
[6] HSU Y C,LIANG I T,HUANG S Y,et al.Transcutaneous electrical acupoint stimulation (TEAS) treatment improves pregnancy rate and implantation rate in patients with implantation failure[J].Taiwan J Obstet Gynecol,2017,56(5):672-676.
[7] 王智超,朱亮.子宫内膜异位症合并不孕患者经体外受精/卵胞质内单精子注射-胚胎移植治疗后妊娠结局及相关因素的分析[J].中华生殖与避孕杂志,2017,37(3):222-226.
[8] 康卉娴,马彩虹,魏瑗,等.体外受精-胚胎移植与单胎妊娠早产风险关系研究[J].中国实用妇科与产科杂志,2017,33(6):609-612.
[9] 冯翠娥,姜宏.40岁以上高龄妇女体外受精/卵胞质内单精子显微注射-胚胎移植临床结局分析[J].生殖与避孕,2015,35(1):62-66.
[10] 李玉梅,巴林林,刘冬娥,等.卵泡期联合黄体期促排卵在卵巢储备功能减退患者实施辅助生殖技术中的应用[J].生殖医学杂志,2014,23(9):728-732.
[11] 孙玲,陈志恒,尹敏娜,等.新鲜周期全胚冷冻策略不影响体外受精-胚胎移植妊娠及产科结局:≤35岁患者的疗效分析[J].南方医科大学学报,2017,37(7):929-932.
[12] 王芳,柯雪,李敏.不同方案GnRH-a降调节对轻中度子宫内膜异位症患者体外受精-胚胎移植结局的影响[J].实用妇产科杂志,2017,33(11):869-872.
[13] KITANO Y,HASHIMOTO S,MATSUMOTO H,et al.Oral admi-nistration of l-carnitine improves the clinical outcome of fertility in patients with IVF treatment[J].Gynecol Endocrinol,2018,34(8):684-688.
[14] 朱洁茹,欧建平,邢卫杰,等.GnRH激动剂长方案与GnRH拮抗剂方案在不同年龄组、不同反应人群中的新鲜周期临床结局比较[J].中山大学学报(医学科学版),2017,38(5):738-745.

相似文献/References:

[1]刘 洋,南 燕,陈 帆,等.不同促排卵方案在高龄卵巢储备功能减退患者中的应用效果比较[J].新乡医学院学报,2020,37(5):465.[doi:10.7683/xxyxyxb.2020.05.016]
 LIU Yang,NAN Yan,CHEN Fan,et al.Application effect of different ovarian stimulation protocols in elderly patients with diminished ovarian reserve[J].Journal of Xinxiang Medical University,2020,37(6):465.[doi:10.7683/xxyxyxb.2020.05.016]

更新日期/Last Update: 2019-06-05