摘要
目的比较不同促排卵方案在高龄(年龄≥40岁)卵巢低反应患者体外受精/卵母细胞浆内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕中的应用效果。方法回顾性分析2013年1月-2015年8月于解放军总医院生殖中心以促性腺激素释放激素激动剂Gn RH-a长方案、Gn RH-a短方案和微刺激方案促排卵行IVF/ICSI助孕的≥40岁卵巢低反应病例(168个周期),比较各组临床资料及结局。结果 3组一般情况、受精率、优质胚胎率、胚胎种植率和临床妊娠率差异均无统计学意义(P>0.05);微刺激方案组促性腺激素(gonadotropin,Gn)用量和使用时间分别为(735.75±725.25)IU及(7.03±2.74)d,显著低于其他两组[(2 749.50±724.50)IU,(9.76±1.40)d;(2 248.50±800.25)IU,(9.51±2.40)d];长方案组获卵数为(5.90±4.44)个,多于短方案组(4.07±2.59)个和微刺激方案组(3.86±3.03)个,差异有统计学意义(P<0.05)。结论微刺激方案Gn用量较小且具有良好的临床结局,对于卵巢储备低下的高龄不孕患者是更加经济、有效的选择。
Objective To compare the effect of different ovarian stimulation protocols in poor ovarian response patients aged 40 years or older for in vitro fertilization（IVF/ICSI）.Methods A total of 168 cycles of 115 patients with poor ovarian response and aged 40 years or older undergoing IVF/ICSI therapy with different methods including long gonadotropin releasing hormone agonist（Gn RH-a） protocol,short Gn RH-a protocol and micro stimulation from January 2013 to August 2015 in Chinese PLA General Hospital were analyzed.They were divided into three groups according to different ovarian stimulation protocols,and the clinical data and outcomes were compared between three groups.Results There was no statistical difference in general characteristics,fertilization rate,the rate of high quality embryo and clinical pregnancy rate（P〈0.05）.But the duration and dosage of gonadotropin（Gn） administration in micro-stimulation protocol group differed significantly comparing with the other two groups [（735.75±725.25） IU vs（2 749.50±724.50） IU,（2 248.50±800.25） IU;（7.03±2.74） d vs（9.76±1.40） d,（9.51±2.40） d,P〉0.05].And long Gn RH-a protocol group got more oocytes retrieved than the other two groups [（5.90±4.44） vs（4.07±2.59）,（3.86±3.03）,P〉0.05].Conclusion Compared with long and short Gn RH-a protocols,micro-stimulation protocol reduces Gn dosage,which seems to be the most economic and effective choice for aged women with poor ovarian response.
出处
《解放军医学院学报》
CAS
2016年第7期750-753,共4页
Academic Journal of Chinese PLA Medical School
关键词
高龄
卵巢低反应
体外受精-胚胎移植
促排卵
advanced age
poor ovarian response
in vitro fertilization-embryo transfer
ovarian stimulation
作者简介
徐晓菲，女，在读硕士。研究方向：生殖医学。Email：sophiexxfly@163．com
通信作者：姚元庆，男，主任医师。Email：yaoyq@126．com
