安徽医科大学学报
安徽醫科大學學報
안휘의과대학학보
Acta Universitatis Medicinalis Anhui
2015年
10期
1489-1493
,共5页
卵巢储备功能下降%双刺激%黄体期促排卵%GnRH拮抗剂
卵巢儲備功能下降%雙刺激%黃體期促排卵%GnRH拮抗劑
란소저비공능하강%쌍자격%황체기촉배란%GnRH길항제
decreased ovarian reserve%double stimulations%controlled ovarian hyperstimulation on luteal phase%GnRH-antagonist
目的 探讨双刺激方案以及微刺激并拮抗剂方案在卵巢储备功能下降( DOR )患者体外受精-胚胎移植( IVF-ET)中的应用. 方法 对283例DOR患者进行回顾性分析,其中双刺激方案204例,拮抗剂方案79例,比较各方案的促排卵结局. 结果 双刺激方案黄体期促排卵的获卵数、可用胚胎数、优质胚胎数、促排天数及用量、扳机日孕酮( P)值均高于卵泡期促排,扳机日黄体生成素( LH)水平低于卵泡期促排. 拮抗剂方案获卵数、优质胚胎数、促排天数和用量高于双刺激卵泡期促排,扳机日 LH 值低于双刺激卵泡期促排,两组可用胚胎数差异无统计学意义. 双刺激黄体期促排天数和用量、扳机日雌二醇( E2 )、P值高于拮抗剂组,扳机日LH值低于拮抗剂组,两组获卵数、可用胚胎数、优质胚胎数差异均无统计学意义. 3 组促排卵周期取消率、获卵率、获可用胚胎率差异无统计学意义. 双刺激方案两期促排卵之后获可用胚胎率较拮抗剂方案高,流产率较低. 结论 双刺激增加的黄体期促排卵在DOR患者中的应用与微刺激联合拮抗剂方案有相同的临床结局,在同一个月经周期中进行双刺激方案缩短了IVF-ET的治疗时间,对于DOR患者是一种可行的方案.
目的 探討雙刺激方案以及微刺激併拮抗劑方案在卵巢儲備功能下降( DOR )患者體外受精-胚胎移植( IVF-ET)中的應用. 方法 對283例DOR患者進行迴顧性分析,其中雙刺激方案204例,拮抗劑方案79例,比較各方案的促排卵結跼. 結果 雙刺激方案黃體期促排卵的穫卵數、可用胚胎數、優質胚胎數、促排天數及用量、扳機日孕酮( P)值均高于卵泡期促排,扳機日黃體生成素( LH)水平低于卵泡期促排. 拮抗劑方案穫卵數、優質胚胎數、促排天數和用量高于雙刺激卵泡期促排,扳機日 LH 值低于雙刺激卵泡期促排,兩組可用胚胎數差異無統計學意義. 雙刺激黃體期促排天數和用量、扳機日雌二醇( E2 )、P值高于拮抗劑組,扳機日LH值低于拮抗劑組,兩組穫卵數、可用胚胎數、優質胚胎數差異均無統計學意義. 3 組促排卵週期取消率、穫卵率、穫可用胚胎率差異無統計學意義. 雙刺激方案兩期促排卵之後穫可用胚胎率較拮抗劑方案高,流產率較低. 結論 雙刺激增加的黃體期促排卵在DOR患者中的應用與微刺激聯閤拮抗劑方案有相同的臨床結跼,在同一箇月經週期中進行雙刺激方案縮短瞭IVF-ET的治療時間,對于DOR患者是一種可行的方案.
목적 탐토쌍자격방안이급미자격병길항제방안재란소저비공능하강( DOR )환자체외수정-배태이식( IVF-ET)중적응용. 방법 대283례DOR환자진행회고성분석,기중쌍자격방안204례,길항제방안79례,비교각방안적촉배란결국. 결과 쌍자격방안황체기촉배란적획란수、가용배태수、우질배태수、촉배천수급용량、반궤일잉동( P)치균고우란포기촉배,반궤일황체생성소( LH)수평저우란포기촉배. 길항제방안획란수、우질배태수、촉배천수화용량고우쌍자격란포기촉배,반궤일 LH 치저우쌍자격란포기촉배,량조가용배태수차이무통계학의의. 쌍자격황체기촉배천수화용량、반궤일자이순( E2 )、P치고우길항제조,반궤일LH치저우길항제조,량조획란수、가용배태수、우질배태수차이균무통계학의의. 3 조촉배란주기취소솔、획란솔、획가용배태솔차이무통계학의의. 쌍자격방안량기촉배란지후획가용배태솔교길항제방안고,유산솔교저. 결론 쌍자격증가적황체기촉배란재DOR환자중적응용여미자격연합길항제방안유상동적림상결국,재동일개월경주기중진행쌍자격방안축단료IVF-ET적치료시간,대우DOR환자시일충가행적방안.
Objective To discuss the value of double stimulations and mild ovarian stimulation combined with Gn-RH-antagonist in patients with decreased ovarian reserve receiving in vitro fertilization and embryo transfer ( IVF-ET) . Methods 283 patients with decreased ovarian reserve who accepted in vitro fertilization were analyzed retro-spectively. 204 cases accepted double stimulations and 79 cases accepted mild ovarian stimulation combined with GnRH-antagonist, compared the outcomes of the two protocols. Results The average number of oocytes retrieved, viable embryos,high-quality embryos,consumption and duration of Gn,the serum progesterone( P) level on trigger day in the luteal phase were significantly higher than those in follicular phase. The serum luteinizing hormone( LH) level on trigger day was lower than that in follicular phase. The average number of oocytes retrieved,high-quality embryos,consumption and duration of gonadotropins( Gn) in mild stimulation combined with GnRH-antagonist were higher than those in follicular phase. LH level on trigger day was lower than those in follicular phase, while the numbers of viable embryos were similar. The consumption and duration of Gn in the luteal phase were higher than in stimulation combined with GnRH-antagonist, and there were no differences in the average number of oocytes re-trieved,viable embryos,high-quality embryos between the two groups. The cycle cancellation rate, available rate of oocytes and embryos were similar between the controlled ovarian hyperstimulation. The available rate of embryos in double stimulations was higher than mild ovarian stimulation combined with GnRH-antagonist,and the abortion rate was lower. Conclusion Controlled ovarian hyperstimulation during luteal phase can get better outcomes in patients with decreased ovarian reserve,double stimulations in the same menstrual cycle shortens the treatment time of IVF-ET,and it is a feasible method for patients with decreased ovarian reserve.
