CAJ | 학술논문

目的比较体外受精-胚胎移植(IVF - ET)中促性腺激素释放激素激动剂(GnRH -a)长方案与促性腺激素释放激素拮抗剂(GnRH -A)方案早期胚胎发育的多项指标,以阐明促性腺激素释放激素(GnRH)类似物对早期胚胎发育的影响.方法将100例卵巢储备正常的行IVF- ET助孕治疗患者随机分为GnRH -a组和GnRH -A组,比较两组的实验室结果、D2、D3不同卵裂细胞数胚胎的比例以及空泡、欠对称、多核及碎片胚胎的比例；比较两组新鲜周期及冷冻胚胎移植(FET)的妊娠与非妊娠移植不同卵裂细胞数胚胎的的比例.结果两组患者的正常受精率、正常受精卵裂率、可用胚胎率、优质胚胎率比较差异无显著性(P＞0.05).GnRH -a组D2＞4细胞胚胎及D38细胞胚胎比例高于GnRH -A组、而D2多核胚胎率、D2及D3碎片胚胎率低于GnRH -A组,以上各率比较差异有显著性(P＜ 0.05); GnRH -a组新鲜周期临床妊娠率高于GnRH -A组,比较差异有显著性(P＜0.05),而两组FET临床妊娠率比较差异无显著性(P＞0.05).GnRH -a组新鲜周期、FET周期的妊娠组与非妊娠组移植胚胎细胞数比例差异无显著性(P＞0.05).GnRH -A组新鲜周期、FET周期的妊娠组移植8-细胞胚胎比例高于非妊娠组,差异有显著性(P＜0.05).结论 GnRH -A方案早期胚胎分裂速度较GnRH -a方案慢,且多核、碎片胚胎的比例高于GnRH -a方案；GnRH -A方案新鲜周期、FET移植D38-细胞胚胎有助于提高临床妊娠率.
목적 비교체외수정-배태이식(IVF - ET)중촉성선격소석방격소격동제(GnRH -a)장방안여촉성선격소석방격소길항제(GnRH -A)방안조기배태발육적다항지표,이천명촉성선격소석방격소(GnRH)유사물대조기배태발육적영향.방법 장100례란소저비정상적행IVF- ET조잉치료환자수궤분위GnRH -a조화GnRH -A조,비교량조적실험실결과、D2、D3불동란렬세포수배태적비례이급공포、흠대칭、다핵급쇄편배태적비례；비교량조신선주기급냉동배태이식(FET)적임신여비임신이식불동란렬세포수배태적적비례.결과 량조환자적정상수정솔、정상수정란렬솔、가용배태솔、우질배태솔비교차이무현저성(P＞0.05).GnRH -a조D2＞4세포배태급D38세포배태비례고우GnRH -A조、이D2다핵배태솔、D2급D3쇄편배태솔저우GnRH -A조,이상각솔비교차이유현저성(P＜ 0.05); GnRH -a조신선주기림상임신솔고우GnRH -A조,비교차이유현저성(P＜0.05),이량조FET림상임신솔비교차이무현저성(P＞0.05).GnRH -a조신선주기、FET주기적임신조여비임신조이식배태세포수비례차이무현저성(P＞0.05).GnRH -A조신선주기、FET주기적임신조이식8-세포배태비례고우비임신조,차이유현저성(P＜0.05).결론 GnRH -A방안조기배태분렬속도교GnRH -a방안만,차다핵、쇄편배태적비례고우GnRH -a방안；GnRH -A방안신선주기、FET이식D38-세포배태유조우제고림상임신솔.
Objective To compare the indicators of early embryo development of gonadotropin-releasing hormone antagonist ( GnRH - a ) long protocol with gonadotropin-releasing hormone agonist ( GnRH - A )protocol,to investigate the influence of GnRH analogues upon early embryo development in vitro fertilization - embryo transfer ( IVF-ET ).Methods 100 patients with normal ovarian reserve undergoing IVF-ET were classified into GnRHa group and GnRHA group randomly.Compared the laboratory results and the radio of blastomere number,vacuole,non-symmetry,multinuclear,and fraction of D2,D3 embryo; and compared the radio of transfer-embryo's cell number between pregnancy and nonpregnancy in fresh and frozen embryo transfer ( FET ) of two groups.Results The rates of normal fertility,normal cleavage,available embryo,and high-quality embryo were not significantly different between two groups(P ＞ 0.05).Otherwise,the radios of D2 multinuclear-embryo and D2,D3 fraction-embryo of Group 1 were significantly lower than Group 2; the radios of D2 ＞ 4-cells embryo and D3 8-cells embryo of Group 1 were significantly more than Group 2,which reached statistical difference(P ＜ 0.05).The pregnancy rate in fresh embryo transfer of Group 1 was higher than Group 2,which there was statistical differences between two groups(P＜ 0.05).No statistical differences were observed on the pregnancy rates in FET between two Groups (P＞ 0.05).There was no significant differences on implantation rates and the radio of cell number of transfer-embryo between pregnancy and non-pregnancy in fresh embryo transfer of Group 1 (P＞ 0.05).The number of 8-cells embryo in pregnancy was more than non-pregnancy in Group 2 ; there was significant difference(P＜ 0.05).Conclusion Early embryonic cleavage of GnRH-A protocol was slower than that of GnRH-A long protocol; and the radios of multinuclear and fraction embryo of GnRH-A protocol were higher than GnRH-A long protocol.8-cells embryo-transfer in fresh and frozen embryo transfer can contribute to increasing pregnancy rate in GnRH-A protocol.