摘要
目的：探讨促排卵过程中添加人绝经期促性腺激素（HMG）对体外受精-胚胎移植（IVF-ET）结局的影响。方法回顾性分析在解放军105医院生殖中心接受IVF-ET治疗的406例不育患者的临床资料，研究对象均于月经第3～5天行重组人促卵泡激素（r-FSH）促超排卵，当卵泡最大直径达14 mm时，A组（257个周期）每天添加HMG 75～150 U（r-FSH＋ HMG组），B组（149个周期）继续使用r-FSH至HCG注射日。按添加 HMG当日的血清黄体生成素（LH）水平，将A组再分为A1组：LH＜1 U/L ，99个周期；A2组：1 U/L≤L H≤2 U/L ，96个周期；A3组：L H＞2 U/L ，62个周期。比较各组的临床结局。结果 A组促性腺激素（Gn）用量、Gn时间、受精率及妊娠率显著高于B组，流产率显著低于对照组，差异有统计学意义（P＜0．05）；两组间添加HMG日及 HCG日血清LH水平、获卵数、卵裂率及胚胎种植率差异均无统计学意义（P＞0．05）。各亚组 HMG的添加剂量随HMG日LH水平升高逐渐减少，差异有统计学意义（P＜0．05）；A3组的Gn时间显著低于A1、A2组，而受精率则显著高于A1、A2组，差异有统计学意义（P＜0．05）；A2的妊娠率显著高于A1组，差异有统计学意义（P＜0．05）。A1、A2、A33组间r-FSH用量、HCG日LH水平、获卵数、卵裂率、胚胎种植率及流产率差异均无统计学意义（P＞0．05）。结论卵泡中晚期添加HMG可提高妊娠率，降低流产率，尤其血清LH在1～2 U/L时添加 HMG可获较好的临床结局。
Objective To explore the effects of human menopausal gonadotropopin（HMG） supplementation on the outcome of women underwent in vitro fertilization-embryo transfer（IVF-ET） .Methods The data of 406 IVF-ET cycles in Reproductive Medi-cine Center of the 105th Hospital of PLA were analyzed retrospectively .All cases underwent long down regulation protocol with gonadotropin releasing hormone agonist（GnRH-a） in the mid-luteal phase and controlled ovarian stimulation（COS） was carried out with follicle stimulation hormone（r-FSH） on the days 3 -5 of the menstrual cycle .Then 75 -150 U HMG was administrated in group A（257 cycles） when a dominant follicle reached a diameter of 14 mm ,while the remaining cases（149 cycles） underwent HCG still with r-FSH were served as group B .Based on the LH levels on the day of HMG administration ,the cases in group A were sub-divided into ：group A1（99 cycles） ,LH〈1 U/L ;group A2（96 cycles） ,1 U/L≤LH≤2 U/L ,and group A3（62 cycles） ,LH〉2 U/L .Clinical outcomes of all groups were analyzed and compared .Results The durations and doses of gonadotropin（Gn） ,the rates of fertilization and pregnancy were higher and the abortion rate was lower in group A than that in group B （P〈0 .05） .There were no significant difference in serum LH concentrations on the days of HMG and HCG administration ,oocytes retrieved ,the rates of cleavage and embryo implantation between group A and group B（P〉0 .05） .There was significant difference in serum LH levels on the day of HMG supplementation among group A1 ,A2 and A3（P〈0 .05） and the doses of HMG supplemented reduced gradually from group A1 to group A3（P〈0 .05） .The duration of Gn was significantly lower and the fertilization rate was significantly higher in group A3 compared with group A1 and A2（P〈0 .05） .The pregnancy rate in group A2 and A3 was higher than that in group A1 ,which showed significant difference between group A2 and A1（P〈0 .05） .Meanwhile ,there were no significant difference in doses of r-FSH ,serum LH concentrations on the day of HCG administration ,oocytes retrieved ,the rates of cleavage ,implantation and abortion among the three groups（P〈0 .05） .Conclusion HMG supplementation in the middle and late follicle phases in stand-ard long down-regulation protocol during IVF could obtain higher pregnancy rate and lower abortion rate ,especially when their ser-um LH level was between 1 U/L and 2 U/L without obvious increase of LH .
出处
《重庆医学》
CAS
CSCD
北大核心
2014年第5期563-565,共3页
Chongqing medicine
关键词
妊娠
体外受精-胚胎移植
黄体生成素
人绝经期促性腺激素
pregnancy
in vitro fertilization-embryo transfer
luteinzing hormone
human menopausal gonadotropin
