摘要
目的探讨卵巢储备功能减退(DOR)患者高孕激素状态下促排卵(PPOS)方案中使用醋酸甲羟孕酮(MPA)和地屈孕酮(DYG)的促排卵效果和实验室结局的差异。方法采用回顾性队列研究方法,收集2022年1月至2023年5月在山西省运城市中心医院生殖医学科采用PPOS方案行常规体外受精(IVF)/卵胞浆内单精子注射(ICSI)助孕的DOR患者的临床资料。共纳入299个周期,根据使用孕激素制剂不同分成MPA组(177个周期)和DYG组(122个周期),比较两组患者的一般资料、促排卵效果及实验室结局。结果两组患者间年龄、体质量指数(BMI)、不孕年限、基础窦卵泡数(AFC)、基础性激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))]水平、ICSI周期占比、周期次数、人绝经期促性腺激素(HMG)天数、HMG总量、HCG日血清LH水平、获卵数、成熟卵率、正常受精率、可用胚胎数、优质胚胎数等比较均无显著性差异(P>0.05);相对于DYG组,MPA组早发LH峰发生率(1.12%vs.6.55%)、HCG日血清E_(2)水平(5732.98 pmol/L vs.6758.45 pmol/L)和孕酮水平(1.97 nmol/L vs.2.07 nmol/L)、孕激素费用(9元vs.90元)均显著降低(P<0.05)。结论对于DOR患者,PPOS方案中使用MPA和DYG均可获得良好的实验室结局,但MPA能够更有效降低早发LH峰发生率,可能是DOR患者PPOS方案的优选孕激素。
Objective:To investigate the difference in ovulation induction effects and laboratory outcomes between medroxyprogesterone acetate(MPA)and dydrogesterone(DYG)in progestin primed ovarian stimulation(PPOS)protocol in patients with diminished ovarian reserve(DOR).Methods:A retrospective study was used to collect clinical data of patients with DOR who received PPOS protocol for IVF/ICSI assisted pregnancy at the Assisted Reproduction Center of Yuncheng Central Hospital from January 2022 to May 2023.A total of 299 cycles were included.The patients were divided into medroxyprogesterone acetate(MPA)group(177 cycles)and dydrogesterone(DYG)group(122 cycles)according to different types of progestin preparations used.The general data,ovulation induction effects and laboratory outcomes of the two groups were compared.Results:There were no significant differences in maternal age,BMI,infertility years,basic antral follicles count(AFC),basal serum levels of FSH,LH and E_(2),percentage of ICSI cycle,cycle number,duration and total dosage of HMG used,serum LH level on HCG day,number of oocytes retrieved,mature oocytes rate,normal fertilization rate,number of available embryos and high-quality embryos between the two groups(P>0.05).The incidence of early LH peak(1.12%vs.6.55%),the levels of E_(2)(5732.98 pmol/L vs.6758.45 pmol/L)and progesterone(1.97 nmol/L vs.2.07 nmol/L)on HCG day and progesterone cost(9 RMB vs.90 RMB)in MPA group were significantly lower than those in DYG group(P<0.05).Conclusions:The use of MPA and DYG in PPOS protocol can achieve good laboratory outcomes for patients with DOR.However,MPA is more effective in controlling early LH peak,and it may be the preferred progestin for DOR patients.
作者
张露云
孙亚婷
刘维凯
高茹
朱爱珍
ZHANG Lu-yun;SUN Ya-ting;LIU Wei-kai;GAO Ru;ZHU Ai-zhen(Assisted Reproduction Center of Yuncheng Central Hospital,Yuncheng 044000)
出处
《生殖医学杂志》
CAS
2024年第1期35-41,共7页
Journal of Reproductive Medicine
关键词
高孕激素状态下促排卵
卵巢储备功能减退
醋酸甲羟孕酮
地屈孕酮
Progestin primed ovarian stimulation
Diminished ovarian reserve
Medroxyprogesterone acetate
Dydrogesterone
作者简介
张露云,女,山西运城人,本科生,检验师,生物技术专业;通讯作者:朱爱珍。
