重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
5期
563-565
,共3页
范静%姜宏%王雪梅%宋小敏%张莹莹
範靜%薑宏%王雪梅%宋小敏%張瑩瑩
범정%강굉%왕설매%송소민%장형형
妊娠%体外受精-胚胎移植%黄体生成素%人绝经期促性腺激素
妊娠%體外受精-胚胎移植%黃體生成素%人絕經期促性腺激素
임신%체외수정-배태이식%황체생성소%인절경기촉성선격소
pregnancy%in vitro fertilization-embryo transfer%luteinzing hormone%human menopausal gonadotropin
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。
目的：探討促排卵過程中添加人絕經期促性腺激素（HMG）對體外受精-胚胎移植（IVF-ET）結跼的影響。方法迴顧性分析在解放軍105醫院生殖中心接受IVF-ET治療的406例不育患者的臨床資料，研究對象均于月經第3～5天行重組人促卵泡激素（r-FSH）促超排卵，噹卵泡最大直徑達14 mm時，A組（257箇週期）每天添加HMG 75～150 U（r-FSH＋ HMG組），B組（149箇週期）繼續使用r-FSH至HCG註射日。按添加 HMG噹日的血清黃體生成素（LH）水平，將A組再分為A1組：LH＜1 U/L ，99箇週期；A2組：1 U/L≤L H≤2 U/L ，96箇週期；A3組：L H＞2 U/L ，62箇週期。比較各組的臨床結跼。結果 A組促性腺激素（Gn）用量、Gn時間、受精率及妊娠率顯著高于B組，流產率顯著低于對照組，差異有統計學意義（P＜0．05）；兩組間添加HMG日及 HCG日血清LH水平、穫卵數、卵裂率及胚胎種植率差異均無統計學意義（P＞0．05）。各亞組 HMG的添加劑量隨HMG日LH水平升高逐漸減少，差異有統計學意義（P＜0．05）；A3組的Gn時間顯著低于A1、A2組，而受精率則顯著高于A1、A2組，差異有統計學意義（P＜0．05）；A2的妊娠率顯著高于A1組，差異有統計學意義（P＜0．05）。A1、A2、A33組間r-FSH用量、HCG日LH水平、穫卵數、卵裂率、胚胎種植率及流產率差異均無統計學意義（P＞0．05）。結論卵泡中晚期添加HMG可提高妊娠率，降低流產率，尤其血清LH在1～2 U/L時添加 HMG可穫較好的臨床結跼。
목적：탐토촉배란과정중첨가인절경기촉성선격소（HMG）대체외수정-배태이식（IVF-ET）결국적영향。방법회고성분석재해방군105의원생식중심접수IVF-ET치료적406례불육환자적림상자료，연구대상균우월경제3～5천행중조인촉란포격소（r-FSH）촉초배란，당란포최대직경체14 mm시，A조（257개주기）매천첨가HMG 75～150 U（r-FSH＋ HMG조），B조（149개주기）계속사용r-FSH지HCG주사일。안첨가 HMG당일적혈청황체생성소（LH）수평，장A조재분위A1조：LH＜1 U/L ，99개주기；A2조：1 U/L≤L H≤2 U/L ，96개주기；A3조：L H＞2 U/L ，62개주기。비교각조적림상결국。결과 A조촉성선격소（Gn）용량、Gn시간、수정솔급임신솔현저고우B조，유산솔현저저우대조조，차이유통계학의의（P＜0．05）；량조간첨가HMG일급 HCG일혈청LH수평、획란수、란렬솔급배태충식솔차이균무통계학의의（P＞0．05）。각아조 HMG적첨가제량수HMG일LH수평승고축점감소，차이유통계학의의（P＜0．05）；A3조적Gn시간현저저우A1、A2조，이수정솔칙현저고우A1、A2조，차이유통계학의의（P＜0．05）；A2적임신솔현저고우A1조，차이유통계학의의（P＜0．05）。A1、A2、A33조간r-FSH용량、HCG일LH수평、획란수、란렬솔、배태충식솔급유산솔차이균무통계학의의（P＞0．05）。결론란포중만기첨가HMG가제고임신솔，강저유산솔，우기혈청LH재1～2 U/L시첨가 HMG가획교호적림상결국。
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 .
