中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
8期
879-881
,共3页
黎淑贞%陈希曦%李冬梅%崔媛媛%陈晓燕
黎淑貞%陳希晞%李鼕梅%崔媛媛%陳曉燕
려숙정%진희희%리동매%최원원%진효연
卵巢储备功能下降%曲普瑞林%体外受精-胚胎移植
卵巢儲備功能下降%麯普瑞林%體外受精-胚胎移植
란소저비공능하강%곡보서림%체외수정-배태이식
Poor ovarian reserve%Triptorelin%In vitro fertilization-embryo transfer
目的 分析卵巢储备功能下降患者使用改良长方案与超长方案进行体外受精-胚胎移植(IVF-ET)的临床结局,旨在寻找更合适的促排卵方案.方法 回顾性分析2011年10月至2012年7月在我院接受体外受精(IVF)或卵细胞浆单精子注射(ICSI)助孕的78例卵巢储备功能下降患者的临床资料.改良长方案43例(A组),黄体中期使用长效曲普瑞林0.375 mg降调,超促排卵启动日加用丙氨瑞林0.15 mg/d至肌肉注射人绒毛膜促性腺激素(HCG)日.超长方案35例(B组),黄体中期使用长效曲普瑞林1.5 mg降调28 d后再次使用曲普瑞林1.2～1.3 mg降调节,16 d后使用促性腺激素(Gn)超促排卵.比较两组Gn剂量、获卵数、可用胚胎数、胚胎种植率、临床妊娠率、流产率.结果 A、B组患者年龄、基础卵泡数、基础促卵泡生成素(FSH)、Gn剂量、获卵数、可用胚胎数、移植胚胎数比较差异均无统计学意义(P均＞0.05),临床妊娠率(32.56％与34.29％)、种植率(18.75％与20.97％)、流产率(0与8.33％)比较差异亦均无统计学意义(P均＞0.05).结论 改良长方案临床妊娠率、流产率与超长方案比较效果相当,但其较超长方案治疗时间短,又避免了可能过度抑制垂体功能的风险.
目的 分析卵巢儲備功能下降患者使用改良長方案與超長方案進行體外受精-胚胎移植(IVF-ET)的臨床結跼,旨在尋找更閤適的促排卵方案.方法 迴顧性分析2011年10月至2012年7月在我院接受體外受精(IVF)或卵細胞漿單精子註射(ICSI)助孕的78例卵巢儲備功能下降患者的臨床資料.改良長方案43例(A組),黃體中期使用長效麯普瑞林0.375 mg降調,超促排卵啟動日加用丙氨瑞林0.15 mg/d至肌肉註射人絨毛膜促性腺激素(HCG)日.超長方案35例(B組),黃體中期使用長效麯普瑞林1.5 mg降調28 d後再次使用麯普瑞林1.2～1.3 mg降調節,16 d後使用促性腺激素(Gn)超促排卵.比較兩組Gn劑量、穫卵數、可用胚胎數、胚胎種植率、臨床妊娠率、流產率.結果 A、B組患者年齡、基礎卵泡數、基礎促卵泡生成素(FSH)、Gn劑量、穫卵數、可用胚胎數、移植胚胎數比較差異均無統計學意義(P均＞0.05),臨床妊娠率(32.56％與34.29％)、種植率(18.75％與20.97％)、流產率(0與8.33％)比較差異亦均無統計學意義(P均＞0.05).結論 改良長方案臨床妊娠率、流產率與超長方案比較效果相噹,但其較超長方案治療時間短,又避免瞭可能過度抑製垂體功能的風險.
목적 분석란소저비공능하강환자사용개량장방안여초장방안진행체외수정-배태이식(IVF-ET)적림상결국,지재심조경합괄적촉배란방안.방법 회고성분석2011년10월지2012년7월재아원접수체외수정(IVF)혹란세포장단정자주사(ICSI)조잉적78례란소저비공능하강환자적림상자료.개량장방안43례(A조),황체중기사용장효곡보서림0.375 mg강조,초촉배란계동일가용병안서림0.15 mg/d지기육주사인융모막촉성선격소(HCG)일.초장방안35례(B조),황체중기사용장효곡보서림1.5 mg강조28 d후재차사용곡보서림1.2～1.3 mg강조절,16 d후사용촉성선격소(Gn)초촉배란.비교량조Gn제량、획란수、가용배태수、배태충식솔、림상임신솔、유산솔.결과 A、B조환자년령、기출란포수、기출촉란포생성소(FSH)、Gn제량、획란수、가용배태수、이식배태수비교차이균무통계학의의(P균＞0.05),림상임신솔(32.56％여34.29％)、충식솔(18.75％여20.97％)、유산솔(0여8.33％)비교차이역균무통계학의의(P균＞0.05).결론 개량장방안림상임신솔、유산솔여초장방안비교효과상당,단기교초장방안치료시간단,우피면료가능과도억제수체공능적풍험.
Objective To compare the outcomes in pregnancy between the patients with poor ovarian reservation receiving ultra-long-term down-regulation protocol and modified long-term protocol who were undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI),aiming at screening an optimal ovulation induction scheme.Methods Retrospectively analyzed the clinical data of 78 patients with poor ovarian reservation who underwent IVF or ICSI from October 2010 to July 2012.Forty-three patients received modified long-term protocol treatment (group A),with 0.375 mg long-acting triptorelin during the midluteal phase as well as superovulation start date plus alarelin (0.15 mg/d) to intramuscular injection of human chorionic gonadotropin (HCG) day.Thirty-five patients received ultra-long-term down-regulation protocol (group B).Triptorelin was injected intramuscularly in mid-luteal phase twice followed by triptorelin at a dose of 1.2-1.3 mg after 28 days of long-acting triptorehn treatment (1.5 mg).Gonadotropin was started 16 days after the second GnRHa injection.The dose of Gn,number of oocytes retrieved,number of embryos available,implantation rate,pregnancy rate,and miscarriage rate were recorded and compared between the two groups.Results There was no significant difference between the two groups in the mean age of participants,basal follicular number,FSH,the dose of Gn used,number of oocytes retrieved,number of embryos available,number of implanted embryos,Pregnancy rate(32.56％ vs.34.29％),implantation rate(18.75％ vs.20.97％) and miscarriage rate (0 vs.8.33％)(P ＞ 0.05).Conclusion No significant difference was found between the two groups in clinical pregnancy rate and abortion rate.But modified long-term protocol needs a shorter treatment period than the ultra-long-term protocol.Moreover,it reduces the risk of excessive suppression of pituitary function.Therefore,it takes advantages over the other in the clinical application.
