浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2013年
13期
1249-1250,1285
,共3页
子宫内膜异位症%超长方案%促性腺激素释放激素激动剂%体外授精-胚胎移植
子宮內膜異位癥%超長方案%促性腺激素釋放激素激動劑%體外授精-胚胎移植
자궁내막이위증%초장방안%촉성선격소석방격소격동제%체외수정-배태이식
Endometriosis(EMs)%Prolonged protocol%GnRH- a%In vitro fertilization and embryo transfer (IVF- ET)
目的探讨改良超长降调节方案启动日LH、E2水平与子宫内膜异位症（EMs）患者体外受精-胚胎移植技术（IVF- ET）结局的关系。方法50例EMs患者（腹腔镜确诊）接受改良超长降调节方案治疗，患者接受GnRH- a治疗3～6个月，每次1.88 mg（1/2支）达菲林肌内注射，间隔28d，第2次注射达菲林后2周开始检测血清CA125，CA125降至18U/L以下后注射末次达菲林1/2支，于末次达菲林注射后2～6周开始用人绝经期促性腺激素（HMG）肌肉注射促进卵泡发育，按启动日血清LH水平分为两组，A1组25例，LH＜0.5U/L,B1组25例，LH≥0.5U/L,比较两组IVF- ET结局。另按启动日E2水平分为两组，A2组E2＜20pg/ml，B2组E2≥20pg/ml，比较两组IVF- ET结局。结果 A1组平均用药天数[（14.71±4.13）d]多于B1组[（8.86±0.49）d]，A1组种植率（24.5%）低于B1组（33.3%）,差异均有统计学意义（均P＜0.05）。A2组与B2组间各项指标未见明显差异。结论改良超长降调节方案治疗EMs患者启动日LH过低将增加HMG用药天数，降低种植率，LH应作为超排启动的主要指标。
目的探討改良超長降調節方案啟動日LH、E2水平與子宮內膜異位癥（EMs）患者體外受精-胚胎移植技術（IVF- ET）結跼的關繫。方法50例EMs患者（腹腔鏡確診）接受改良超長降調節方案治療，患者接受GnRH- a治療3～6箇月，每次1.88 mg（1/2支）達菲林肌內註射，間隔28d，第2次註射達菲林後2週開始檢測血清CA125，CA125降至18U/L以下後註射末次達菲林1/2支，于末次達菲林註射後2～6週開始用人絕經期促性腺激素（HMG）肌肉註射促進卵泡髮育，按啟動日血清LH水平分為兩組，A1組25例，LH＜0.5U/L,B1組25例，LH≥0.5U/L,比較兩組IVF- ET結跼。另按啟動日E2水平分為兩組，A2組E2＜20pg/ml，B2組E2≥20pg/ml，比較兩組IVF- ET結跼。結果 A1組平均用藥天數[（14.71±4.13）d]多于B1組[（8.86±0.49）d]，A1組種植率（24.5%）低于B1組（33.3%）,差異均有統計學意義（均P＜0.05）。A2組與B2組間各項指標未見明顯差異。結論改良超長降調節方案治療EMs患者啟動日LH過低將增加HMG用藥天數，降低種植率，LH應作為超排啟動的主要指標。
목적탐토개량초장강조절방안계동일LH、E2수평여자궁내막이위증（EMs）환자체외수정-배태이식기술（IVF- ET）결국적관계。방법50례EMs환자（복강경학진）접수개량초장강조절방안치료，환자접수GnRH- a치료3～6개월，매차1.88 mg（1/2지）체비림기내주사，간격28d，제2차주사체비림후2주개시검측혈청CA125，CA125강지18U/L이하후주사말차체비림1/2지，우말차체비림주사후2～6주개시용인절경기촉성선격소（HMG）기육주사촉진란포발육，안계동일혈청LH수평분위량조，A1조25례，LH＜0.5U/L,B1조25례，LH≥0.5U/L,비교량조IVF- ET결국。령안계동일E2수평분위량조，A2조E2＜20pg/ml，B2조E2≥20pg/ml，비교량조IVF- ET결국。결과 A1조평균용약천수[（14.71±4.13）d]다우B1조[（8.86±0.49）d]，A1조충식솔（24.5%）저우B1조（33.3%）,차이균유통계학의의（균P＜0.05）。A2조여B2조간각항지표미견명현차이。결론개량초장강조절방안치료EMs환자계동일LH과저장증가HMG용약천수，강저충식솔，LH응작위초배계동적주요지표。
Objective To evaluate the effect of serum LH,E2 level on the day of superovulation start on the prolonged go-nadotropin- releasing hormone agonist therapy on the outcomes of IVF- ET in patients with edometriosis. Methods Fifty patients received three to six courses of long- acting GnRH agonist, 1.88mg i.m. every 28 days. HMG was started 14~42days later. Con-ventional IVF- ET was performed as routine procedure. All patients were divided into two groups according to the level of serum LH and E2.Group A1 include 25 patients whose level of LH was less than 0.5U/L, Group B1 include 25 patients whose level of LH was over 0.5U/L.The other way , Group A2 include 30 patients whose level of E2 was less than 20pg/ml, Group B2 include 20 pa-tients whose level of E2 was over 20pg/ml. Results The total gonadotropin (Gn) used days were 14.71±5.44 (day) in group A1, more than that in group B1(8.86±0.49 day). The implantation rate in group A1 (24.5%)was lower than in group B1(33.3%). Con-clusion If the serum LH,level on the day of superovulation start on the prolonged gonadotropin- releasing hormone agonist thera-py was too low,It maybe decrease the implantation rate,It laso increase the total gonadotropin used days.
