摘要
目的:评估坤泰胶囊联合高孕激素促排卵(progestin-primed ovarian stimulation,PPOS)方案对预期卵巢低反应(poor ovarian response,POR)患者体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)周期中卵巢反应、胚胎实验室和移植妊娠结局的影响。方法:回顾性队列研究分析2020年6月至2023年7月期间于江西省妇幼保健院生殖医学中心行IVF/ICSI助孕的1733例预期POR患者临床资料,按照1∶1倾向性评分匹配分为单一PPOS方案组(对照组)和坤泰胶囊联合PPOS方案组(试验组),每组各423例。分析两组的促排卵和实验室结局,并比较所获胚胎首次冻融移植周期的妊娠结局。主要观察指标为获卵数。结果:匹配后组间基线资料差异均无统计学意义(均P>0.05)。与对照组相比,试验组的获卵数差异无统计学意义(P=0.295)。扳机日试验组的黄体生成素(luteinizing hormone,LH)水平[3.3(2.2,5.0)U/L]、可利用囊胚形成数[1(0,1)个]和可利用囊胚形成率[46.2%(85/184)]均显著高于对照组[2.9(1.9,4.5)U/L,P=0.004;0(0,1)个,P=0.034;30.0%(48/160),P=0.002]。两组促性腺激素使用时间和使用总量、扳机日孕酮和雌二醇水平、早发LH峰比例、正常受精数/率、正常卵裂数/率、优质胚胎数/率和无可利用胚胎率等差异均无统计学意义(均P>0.05)。试验组和对照组相比,首次冻融胚胎移植后的种植率、临床妊娠率、早期流产率、持续妊娠率和活产率组间比较差异均无统计学意义(均P>0.05)。结论:相较于单一PPOS方案组,坤泰胶囊联合PPOS促排卵未显著增加预期POR患者的获卵数,但可增加可利用囊胚形成数和可利用囊胚形成率。
ObjectiveTo evaluate the effect of Kuntai capsules combined with progestin-primed ovarian stimulation(PPOS)protocol on the ovarian response,laboratory parameters and embryo transfer outcomes of expected poor ovarian response(POR)patients undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)cycles.MethodsA retrospective cohort study was performed at Center for Reproductive Medicine,Jiangxi Maternal and Child Health Hospital from June 2020 to July 2023.A total of 1733 expected POR patients were enrolled and divided into the PPOS only group(control group)and the Kuntai capsules combined with PPOS regimen group(trial group).After a 1∶1 propensity score matching,423 cases were included in each group.Further analyses and comparisons were made between the two groups,concerning the ovarian stimulation outcomes,embryo laboratory parameters and pregnancy rates after the first frozen-thawed embryo transfer cycles.The primary outcome measure was the number of oocytes retrieved.ResultsNo statistically significant difference was found in baseline characteristics after matching between the two groups(all P>0.05).Compared with control group,the number of oocytes retrieved did not differ significantly in the trial group(P=0.295).The level of luteinizing hormone(LH)on the trigger day[3.3(2.2,5.0)U/L],the number of available blastocysts formed[1(0,1)]and the available blastocyst formation rate[46.2%(85/184)]in the trial group were significantly higher than those in control group[2.9(1.9,4.5)U/L,P=0.004;0(0,1),P=0.034;30.0%(48/160),P=0.002].However,there were no significant differences in the duration and dosage of gonadotropin used,progesterone and estradiol levels on the trigger day,incidence of premature LH surge,number/rate of fertilized oocytes,number/rate of cleaved embryos,number/rate of high-quality embryos,as well as rate of unavailable embryos(all P>0.05).Compared with control group,the trial group demonstrated comparable implantation rate,clinical pregnancy rate,early miscarriage rate,ongoing pregnancy rate and live birth rate after the first frozen-thawed embryo transfer cycles(all P>0.05).ConclusionCompared with the PPOS only regimen,the combination of Kuntai capsules and PPOS did not increase the number of oocytes retrieved but could increase the number and rate of available blastocysts formed in expected POR patients.
作者
黄玲玲
谢琦琦
夏雷震
田莉峰
许定飞
左慧君
黎梦溪
李韵君
张珂
伍琼芳
黄嘉膂
Huang Lingling;Xie Qiqi;Xia Leizhen;Tian Lifeng;Xu Dingfei;Zuo Huijun;Li Mengxi;Li Yunjun;Zhang Ke;Wu Qiongfang;Huang Jialyu(Center for Reproductive Medicine,Jiangxi Maternal and Child Health Hospital,Nanchang 330000,China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2024年第9期916-921,共6页
Chinese Journal of Reproduction and Contraception
基金
江西省中医药管理局科技计划项目(2022B184)
江西省自然科学基金(20224BAB216025)
国家自然科学基金(82260315)
。
关键词
受精
体外
坤泰胶囊
高孕激素促排卵
卵巢低反应
Fertilization in vitro
Kuntai capsules
Progestin-primed ovarian stimulation
Poor ovarian response
作者简介
通信作者:黄嘉膂,Email:huangjialv_medicine@foxmail.com,电话:+86-791-88829017。
