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（ GnRH ）拮抗剂方案、与GnRH激动剂长方案治疗多囊卵巢综合征（ PCOS ）患者的助孕结局。方法行IVF-ET的PCOS不孕患者118例，其中研究组48例采用GnRH拮抗剂方案，对照组70例采用GnRH激动剂长方案，比较分析两组的助孕结局。结果两组的平均获卵数、卵母细胞成熟率、受精率、卵裂率、优质胚胎率、胚胎种植率、临床妊娠率、卵泡液的IL-1β浓度比较差异均无统计学意义（ P＞0．05）；研究组的促性腺激素（ Gn）使用时间和Gn用量明显少于对照组（ P＜0．05），卵巢过度刺激综合征（ OHSS ）发生率和周期取消率低于对照组（ P＜0．05）。结论 GnRH拮抗剂方案治疗PCOS不孕症能降低OHSS发生风险、减少周期取消率及减少Gn使用时间及其用量，而平均获卵数、受精率、卵裂率、优质胚胎率、临床妊娠率、种植率均不受影响。
목적：비교체외수정-배태이식（ IVF-ET ）중촉성선격소석방격소（ GnRH ）길항제방안、여GnRH격동제장방안치료다낭란소종합정（ PCOS ）환자적조잉결국。방법행IVF-ET적PCOS불잉환자118례，기중연구조48례채용GnRH길항제방안，대조조70례채용GnRH격동제장방안，비교분석량조적조잉결국。결과량조적평균획란수、란모세포성숙솔、수정솔、란렬솔、우질배태솔、배태충식솔、림상임신솔、란포액적IL-1β농도비교차이균무통계학의의（ P＞0．05）；연구조적촉성선격소（ Gn）사용시간화Gn용량명현소우대조조（ P＜0．05），란소과도자격종합정（ OHSS ）발생솔화주기취소솔저우대조조（ P＜0．05）。결론 GnRH길항제방안치료PCOS불잉증능강저OHSS발생풍험、감소주기취소솔급감소Gn사용시간급기용량，이평균획란수、수정솔、란렬솔、우질배태솔、림상임신솔、충식솔균불수영향。
Objective To compare the treatment outcomes between gonadotropin-releasing hormone ( GnRH) antagonist protocol and GnRH agonist long protocol applied to polycystic ovary syndrome ( PCOS) patients undergoing in vitro fertilization and embryo transfer ( IVF-ET ) .Methods One hundred and eighteen cases of PCOS patients undergoing IVF-ET were divided randomly into study groupcontrol group .Forty-eight patients in study group were subjected to a protocol of using GnRH antagonist .Seventy patients in control group were subjected to a long protocol of using GnRH agonist.The clinical outcomes of two groups were compared .Results There were no significant differences in the average number of oocyte,the mature rate of oocytes,the fertilization rate,the cleavage rate,the rate of high-quality embryos, the implantation rate,the pregnancy rate and the concentration of IL-1βin follicular fluid between two groups(P>0.05). The time and doses of administration of gonadotropins in the study group were obviously less than those in the control group (P<0.05).The incidence and cycle cancellation rate of ovarian hyperstimulation syndrome (OHSS) in the study group were significantly lower than those in the control group(P<0.05).Conclusion The GnRH antagonist protocol could decrease the incidence ,cycle cancellation rate of OHSS as well as reduce the time and doses of administration of gonadotropins . However,the number of oocyte ,the fertilization rate,the cleavage rates,the rate of high-quality embryos,the pregnancy rate and the implantation rate are not affected .