CAJ | 학술논문

目的探讨改良超长方案在体外受精-胚胎移植的患者中的临床应用情况.方法回顾性分析在郑州大学第三附属医院生殖中心行体外受精-胚胎移植的卵巢反应稍低患者95例.50例应用改良超长方案(A组),其中15例第一次长方案未孕后用改良超长方案,另35例为子宫内膜异位症患者;45例应用长方案(B组);15例患者第一次用长方案未成功,后应用改良超长方案,分别归为C组和D组进行自身对照分析.分别计算A、B、C、D组患者Gn使用剂量、天数、人绒毛膜促性腺激素(HCG)日激素水平及内膜厚度、获卵数、受精率、卵裂率、优胚率、临床妊娠率、流产率,并进行统计学分析.结果 ①A、B两组患者的年龄、不孕年限、体质量指数、各基础内分泌激素水平及双侧窦卵泡数组间比较差异均无统计学意义(P＞0.05);②A组Gn使用天数、HCG注射日子宫内膜厚度高于B组(P＜0.05);B组HCG注射日促黄体生成素(LH)水平高于A组(P＜0.05),患者Gn用量、HCG注射日雌三醇(E2)及孕激素(P)组间比较差异无统计学意义(P＞0.05);③A、B两组患者获卵数、周期取消率、受精率、卵裂率、优质胚胎率、临床妊娠率、流产率组间比较差异均无统计学意义(P＞0.05);④D组Gn使用天数、HCG注射日子宫内膜厚度高于C组(P＜0.05),D组HCG注射日LH水平低于C组(P＜0.05),C、D组患者Gn用量、HCG注射日E2及P组间比较差异无统计学意义(P＞0.05);⑤C、D组患者获卵数、周期取消率、受精率、卵裂率、优质胚胎率组间比较差异均无统计学意义(P＞0.05),D组中临床妊娠率为33.33％,这些患者在第1次长方案时均未妊娠.结论对卵巢配备稍低和子宫内膜异位症的患者改良超长降调节方案是一种较好的促排方案.
목적 탐토개량초장방안재체외수정-배태이식적환자중적림상응용정황.방법 회고성분석재정주대학제삼부속의원생식중심행체외수정-배태이식적란소반응초저환자95례.50례응용개량초장방안(A조),기중15례제일차장방안미잉후용개량초장방안,령35례위자궁내막이위증환자;45례응용장방안(B조);15례환자제일차용장방안미성공,후응용개량초장방안,분별귀위C조화D조진행자신대조분석.분별계산A、B、C、D조환자Gn사용제량、천수、인융모막촉성선격소(HCG)일격소수평급내막후도、획란수、수정솔、란렬솔、우배솔、림상임신솔、유산솔,병진행통계학분석.결과 ①A、B량조환자적년령、불잉년한、체질량지수、각기출내분비격소수평급쌍측두란포수조간비교차이균무통계학의의(P＞0.05);②A조Gn사용천수、HCG주사일자궁내막후도고우B조(P＜0.05);B조HCG주사일촉황체생성소(LH)수평고우A조(P＜0.05),환자Gn용량、HCG주사일자삼순(E2)급잉격소(P)조간비교차이무통계학의의(P＞0.05);③A、B량조환자획란수、주기취소솔、수정솔、란렬솔、우질배태솔、림상임신솔、유산솔조간비교차이균무통계학의의(P＞0.05);④D조Gn사용천수、HCG주사일자궁내막후도고우C조(P＜0.05),D조HCG주사일LH수평저우C조(P＜0.05),C、D조환자Gn용량、HCG주사일E2급P조간비교차이무통계학의의(P＞0.05);⑤C、D조환자획란수、주기취소솔、수정솔、란렬솔、우질배태솔조간비교차이균무통계학의의(P＞0.05),D조중림상임신솔위33.33％,저사환자재제1차장방안시균미임신.결론 대란소배비초저화자궁내막이위증적환자개량초장강조절방안시일충교호적촉배방안.
Objective To investigate the clinical application of the modified super-long downregulation protocol in patients with inviro fertilization-embryo transferation (IVF-ET).Methods The clinical data of 95 patients with lower ovarian reponse underwent IVF-ET were analyzed retrospectively.Among them,50 cases (group A) accepted modified super-long down-regulation protocol,45 cases (group B) accepted long down-regulation protocol.Fifteen patients in group A were given first long down-regulation protocol without success(group C),and then were given modified super-long down-regulation protocol(Group D).The duration of stimulation,total dose of Gn,E2 level on HCG day,number of eggs retrieved,rate of high quality embryo,clinical pregnancy rate were compared between the groups.Results ①There were no significant differences in age,infertility duration,BMI,various endocrine hormone levels or the number of the bilateral antral follicle (P ＞ 0.05).②The days of using Gn,endometrial thickness on HCG injecting day in group A were higher than those in group B (P ＜ 0.05),the level of LH on HCG injecting day in group A was lower than that in group B(P ＜0.05),there were no significant differences in the dosage of Gn,E2 and P levels on HCG injecting day between the two groups (P ＞ O.05).③There were no significant differences in the number of oocyte,the rate of cancellation,the rate of fertilization,the rate of cleavage,the rate of high-quality embryo or clinical pregnancy rate (P ＞ 0.05) between the two groups.④ The days of using Gn,endometrial thickness on HCG injecting day in group D were higher than those in group C (P ＜ 0.05),the level of LH on HCG injecting day in group D was lower than that in group C (P ＜ 0.05).⑤ There were no significant differences in the number of oocyte,the rate of cancellation,the rate of fertilization,the rate of cleavage,the rate of high-quality embryo or clinical pregnancy rate between the two groups (P ＞ 0.05).Conclusions Modified super-long down-regulation protocol is an effective method for ovulation.