CAJ | 학술논문

目的探讨超长降调节方案超排启动日血清LH水平对卵巢内膜异位囊肿患者体外受精-胚胎移植(IVF-ET)结局的影响.方法 75例卵巢内膜异位囊肿患者在腹腔镜或开腹下行囊肿剥出术或经阴道B超引导下囊肿穿刺术后每28 d注射促性腺激素释放激素激动剂(GnRH-α)共3～4次,末次注射后14～84 d予促性腺激素(Gn)超排卵行IVF-ET治疗,按超排启动日血清LH水平分为两组,A组30例,LH<0.5 IU/L,B组45例,0.5IU/L≤LH<1.5 IU/L,比较两组患者IVF-ET结局的差异.结果 A组使用Gn的总量[(32.28±7.7)支]及人类绝经期促性腺激素(hMG)的用量[(12.0±8.9)支]多于B组[(25.84±7.1)支,(6.19±7.4)支],胚胎植入率低于B组[A组18.1%vs B组26.7%],差异均有统计学意义(P<0.05).结论超长降调节方案超排卵启动日血清LH水平过低将增加IVF-ET治疗中Gn用量,降低胚胎植入率,LH水平应作为超排启动的主要参考指标.
목적 탐토초장강조절방안초배계동일혈청LH수평대란소내막이위낭종환자체외수정-배태이식(IVF-ET)결국적영향.방법 75례란소내막이위낭종환자재복강경혹개복하행낭종박출술혹경음도B초인도하낭종천자술후매28 d주사촉성선격소석방격소격동제(GnRH-α)공3～4차,말차주사후14～84 d여촉성선격소(Gn)초배란행IVF-ET치료,안초배계동일혈청LH수평분위량조,A조30례,LH<0.5 IU/L,B조45례,0.5IU/L≤LH<1.5 IU/L,비교량조환자IVF-ET결국적차이.결과 A조사용Gn적총량[(32.28±7.7)지]급인류절경기촉성선격소(hMG)적용량[(12.0±8.9)지]다우B조[(25.84±7.1)지,(6.19±7.4)지],배태식입솔저우B조[A조18.1%vs B조26.7%],차이균유통계학의의(P<0.05).결론 초장강조절방안초배란계동일혈청LH수평과저장증가IVF-ET치료중Gn용량,강저배태식입솔,LH수평응작위초배계동적주요삼고지표.
Objective To evaluate the effect of serum LH level on the day of superovulation start on the prolonged gonadotropin-releasing hormone ngonist therapy on the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in patents with ovarian endometriomas. Methods 75 patients with ovarian en-dometriomas were treated by laparoscopic cystectomy or laparotomy cystectomy or ultrasound-mediated cysts puncture, and gonadotropin-releasing hormone agonist (GnRH-α) was given for 3 to 4 times every 28 days after the operation. Superovulation started after 14 ～ 84 days of the last injection. All the patients were di-vided into two groups according to the level of serum LH. Group A included 30 patients whose level of LH was less than 0. 5IU/L, and group B included 45 patients whose level of LH was over 0.5IU/L and less than 1.5IU/L. The outcomes of IVF-ET were evaluated. Results The total ampoules of Gn administration and the ampoules of hMG needed in group A[(32.28±7.7) ampoules, ( 12.0±8. 9) ampoules,]were sig-nificantly more than that in group B[( 25.84±7. 1 ) ampoules, ( 6. 19±7.4) ampoules, P < 0.05] . The successful embryo implantation rate in group A( 18. 1% ) was lower than group B(26. 7% ), and the differ-ence has statistical significance ( P <0. 05). Conclusion The low level of serum LH on the superovula-lion day on the prolonged gonadotropin-releasing hormone agonist protocol will increase the ampoules of Gn administration and decrease the successful embryo implantation rate of IVF-ET, thus LH should be a more important reference parameter of superovulation start.