CAJ | 학술논문

目的：探讨卵巢储备功能正常的中、重度子宫内膜异位症（简称内异症）患者应用超长方案行 IVF的促排卵及妊娠结局。方法回顾性分析2007年1月—2011年12月中、重度内异症患者应用超长方案行 IVF促排卵及妊娠结局（观察组，95个周期）及同期单纯输卵管因素患者应用黄体期长方案行 IVF 促排卵及妊娠结局（对照组，1654个周期）。结果观察组 Gn 总量高于对照组[（44．4±9．9）U，（25．5±7．1）U]，获卵数[（10．4±4．8）个]及可利用胚胎数[（3．7±2．3）个]低于对照组[（11．5±4．3）个，（5．3±3．2）个]。观察组 Gn 启动日[（0．46±0．26）U ／L]及 hCG 日血清 LH 水平[（0．47±0．26）U／L]低于对照组[（1．01±0．56）U／L，（1．38±4．75）U／L]。两组临床妊娠率、种植率、流产率、分娩率比较，差异均无统计学意义。结论对于卵巢储备功能正常的中、重度内异症患者，应用超长方案促排卵可获得良好的妊娠结局。超长方案对垂体抑制较强，卵巢反应性降低。
목적：탐토란소저비공능정상적중、중도자궁내막이위증（간칭내이증）환자응용초장방안행 IVF적촉배란급임신결국。방법회고성분석2007년1월—2011년12월중、중도내이증환자응용초장방안행 IVF촉배란급임신결국（관찰조，95개주기）급동기단순수란관인소환자응용황체기장방안행 IVF 촉배란급임신결국（대조조，1654개주기）。결과관찰조 Gn 총량고우대조조[（44．4±9．9）U，（25．5±7．1）U]，획란수[（10．4±4．8）개]급가이용배태수[（3．7±2．3）개]저우대조조[（11．5±4．3）개，（5．3±3．2）개]。관찰조 Gn 계동일[（0．46±0．26）U ／L]급 hCG 일혈청 LH 수평[（0．47±0．26）U／L]저우대조조[（1．01±0．56）U／L，（1．38±4．75）U／L]。량조림상임신솔、충식솔、유산솔、분면솔비교，차이균무통계학의의。결론대우란소저비공능정상적중、중도내이증환자，응용초장방안촉배란가획득량호적임신결국。초장방안대수체억제교강，란소반응성강저。
Objective To examine the outcome of in vitro fertilization (IVF)after long-term pituitary down-regulation for women with moderate or severe endometriosis and normal ovarian reserve. Methods A retrospective analysis was performed on 95 prolonged protocol IVF cycles for women with moderate or severe endometriosis and normal ovarian reserve.A total of 1654 long protocol IVF-ET cycles performed during the same period with tubal infertility and normal ovarian reserve were considered as controls. Results The doses of gonadotropins were significantly higher in the group with endometriosis than in the tubal factor group (44.4 ±9.9 U vs.25.5 ±7.1 U,P <0.05).The number of retrieved oocytes and the number of transferable embryos were significantly lower in the endometriosis group than in the tubal factor group (10.4 ±4.8 vs.11.5 ±4.3,and 3.7 ±2.3 vs.5.3 ±3.2,respectively).The levels of luteinizing hormone on gonadotropins (Gn)launch day and hCG injection day were significantly lower in the endometriosis group than in the tubal factor group (0.46 ±0.26 U /L vs.1.01 ±0.56 U /L,and 0.47 ±0.26 U /L vs.1.38 ±4.75 U /L,respectively).The clinical pregnancy (69.2% vs.70.2%),implantation (47.6% vs.51.5%),miscarriage (14.3% vs.9.7%)and delivery rate (58.2% vs. 61.5%)were comparable between the two groups. Conclusion The outcomes of IVF conducted with prolonged GnRH-a protocol on women with moderate or severe endometriosis were good if the women had normal ovarian reserve.However, ovarian response decreased in the endometriosis group after long-term pituitary down-regulation.