摘要
目的探讨改良短方案和拮抗剂方案对卵巢储备功能低下患者疗效及其妊娠结局的影响。方法选择2017-2019年在该院行体外受精-胚胎移植技术(IVF-ET)和卵泡浆内单精子纤维注射(ICSI)的不孕不育患者(共100取卵周期),根据促进排卵的方案不同分为观察组(43周期)和对照组(57周期)。观察组的促排卵方案为改良短方案,对照组为拮抗剂方案。2组均使用IVF-ET/ICSI,比较2组不同时期激素水平、人促性腺激素(Gn)使用时间、Gn使用量、内膜厚度、获卵数、受精率、优质胚胎率、移植胚胎数和妊娠结局。结果2组基础激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇和孕酮]水平比较,差异无统计学意义(P>0.05),在Gn启动日前观察组血清FSH、LH和雌二醇水平明显低于对照组(P<0.05),而孕酮水平比较,差异无统计学意义(P>0.05)。在人绒毛膜促性腺激素注射日观察组血清LH、雌二醇水平和孕酮/雌二醇明显低于对照组(P<0.05),而2组血清孕酮水平比较,差异无统计学意义(P>0.05)。观察组的Gn使用时间明显长于对照组,Gn使用量、内膜厚度和获卵数明显高于对照组(P<0.05),而2组受精率、优质胚胎率、移植胚胎数、周期取消率、临床妊娠率、着床率、流产率、异位妊娠率和持续妊娠率比较,差异无统计学意义(P>0.05)。结论改良短方案和拮抗剂方案对卵巢储备功能低下患者均有较好的疗效,改良短方案在改善患者激素水平和子宫内膜方面具有明显优势。
Objective To investigate the effects of modified short regimen and antagonist regimen on the curative effect of patients with low ovarian reserve function and their pregnancy outcome.Methods A total of 100 oocyte retrieval cycles were selected from infertility patients who underwent in vitro fertilization and embryo transfer(IVF-ET)and intracytoplasmic sperm injection(ICSI)in the hospital from 2017 to 2019.According to different ovulation promotion schemes,they were divided into observation group(43 cycles)and control group(57 cycles).The ovulation induction program of the observation group was modified short program,and the control group was antagonist program.IVF-ET/ICSI was used in both groups.The hormone levels,the use time of human gonadotropin(Gn),the use amount of Gn,the thickness of endometrium,the number of retrieved eggs,the fertilization rate,the rate of high-quality embryos,the number of transferred embryos and the pregnancy outcome were compared.Results There were no significant differences in the basal levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol and progesterone between the two groups(P>0.05).Before the start of Gn,the levels of FSH,LH and estradiol in the observation group were sigificantly lower than those in the control group(P<0.05),but there was no significant difference in the level of progesterone(P>0.05).On the day of human chorionic gonadotropin injection,the levels of serum LH,estradiol and progesterone/estradiol in the observation group were significantly lower than those in the control group(P<0.05),but there was no significant difference in the level of progesterone(P>0.05).The use time of Gn in the observation group was significantly longer than that in the control group,and the amount of Gn used,endometrial thickness and the number of retrieved eggs were significantly higher than those in the control group(P<0.05).There were no significant differences in the fertilization rate,high-quality embryo rate,number of transferred embryos,cycle cancellation rate,clinical pregnancy rate,implantation rate,abortion rate,ectopic pregnancy rate and persistent pregnancy rate between the two groups(P>0.05).Conclusion Both modified short regimen and antagonist regimen have good curative effect on patients with low ovarian reserve function.Modified short regimen has obvious advantages in improving hormone level and endometrium.
作者
王娜
邵红芳
邢长英
戴雪
陶敏芳
WANG Na;SHAO Hongfang;XING Changying;DAI Xue;TAO Minfang(Department of Reproductive Medicine Center,the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233)
出处
《检验医学与临床》
CAS
2021年第14期2038-2042,共5页
Laboratory Medicine and Clinic
关键词
不孕不育
高龄
卵巢储备
体外受精
促排卵方案
infertility
advanced age
ovarian reserve
in vitro fertilization
ovulation induction program
