摘要
目的:探讨GnRH-a长方案周期中出现卵泡发育不同步患者采用大卵泡穿刺抽吸治疗后对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法:对64例GnRH-a长方案周期中出现卵泡发育不同步患者的临床资料进行回顾性分析,根据促性腺激素(Gn)启动10日内是否进行大卵泡穿刺抽吸治疗分为穿刺抽吸组(31例)和未穿刺抽吸组(33例),比较两组患者启动Gn4～6天和启动Gn7～10天卵泡发育不同步情况、促排卵用药情况及妊娠结局,以及未穿刺抽吸组患者取卵时卵泡中有卵子和无卵子(即囊肿)情况及其临床妊娠率的比较。结果:①两组启动Gn4～6天和启动Gn7～10天时,出现卵泡发育不同步情况比较,差异无统计学意义(P>0.05)。②两组患者GnRH-a剂量、GnRH-a天数、Gn天数、Gn总量、HCG日内膜厚度、HCG日E2/P值、获卵数、获卵率、成熟卵数、成熟卵率、优质胚胎数、临床妊娠率和流产率比较,差异均无统计学意义(P>0.05)。③未穿刺抽吸组患者仅依靠Gn使用的调整,取卵日大卵泡中有卵子与证实为囊肿的患者的临床妊娠率比较,差异无统计学意义(P=1.000)。结论:卵泡的不同步发育可以发生在GnRH-a长方案控制性超促排卵的不同时间,出现卵泡发育不同步现象不需要中途进行穿刺抽吸治疗,其与通过调整Gn的使用来调节卵泡的发育而获得的妊娠结局相同。
Objective： To explore the influences of aspirating big follicles to the results of vitro fertilization-embryo transfer when the follicles develop non-synchronously in COH with GnRH-a long protocol, Methods：64 patiets who were treated in COH with GnRH-a long protocol and the follicles develop non-synchronously were included in the retrospective study, They were divided into the with aspiration group（ n =31 ） and the no aspiration group （n =33） in accordance with whether to aspirate big follicles within 10 days of ovarian stimulation, The clinical data including timing when the follicles develop non-synchronously,the medicine ofovarian stimulation ,the pregnancy outcome,and compared of the not aspiration group had and had not ovum （mean hydatoncus） when oocytes were retrieved were compared between the two groups. Results：①There was no significant difference in the follicles developed nonsynchronously between these two groups within ovarian stimulation 4 - 6 days or 7 - 10 days（ P 〉 0.05）. ②Between the two groups, there was no significant difference in the dosage of GnRH-a,the days of GnRH-a,the days of ovarian stimulation,the total gonadotropin dosage, the thickness of endometrium in the day of HCG administration （day-of-HCG）, the ratio of estra diol/pregnendione in the day-of-HCG,the numbers of retrievaled oocytes,the rate of retrievaled oocytes,the number of mature oocytes,the rate of mature oocytes,the rate of pregnancy and the rate of abortion （ P 〉 0. 05）. ③The patients in the no aspiration group who relied on regulating the gonadotropin, and the pregnancy rates was no significant different from those whose big follicles were confirmed be ovum and be hydatoncus（ Fisher＇s Exact Test, P = 1. 000）. Conclusions：The follicles develop non-synchronously may occurs in different timing of COH with GnRH-a long protocol. It need not to aspirate the big follicles in midway when the follicle develop non-synchronously, because the pregnancy outcome is the same as the group which just through regulating the gonadotropin to adjust the follicles development.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2013年第2期125-128,共4页
Journal of Practical Obstetrics and Gynecology
