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-  2016 

不同促排卵方案在体外受精-胚胎移植中应用的比较 Comparison of Different Ovarian Hyperstimulation Protocol in in vitro Fertilization-Embryo Transfer

Keywords: 体外受精-胚胎移植,促排卵方案,GnRH拮抗剂,GnRH激动剂

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Abstract:

目的:比较不同促排卵方案在体外受精-胚胎移植中应用的有效性,为促排卵方案临床合理应用提供依据。方法:2013年1月至2015年6月在我院生殖医学中心接受长方案(599个周期)、短方案(202个周期)及拮抗剂方案(123个周期)治疗的患者,观察其胚胎发育、临床妊娠结局及并发症情况等。结果:长方案组与拮抗剂组的平均年龄[(32.75±4.45)和(33.97±5.09)岁]及基础FSH[(7.23±2.32)和(7.97±3.57)IU/L]均显著低于短方案组[(36.04±4.87)岁;(10.07±5.37)IU/L]。长方案组的平均获卵数最高(13.27±6.69),短方案组最低(7.72±5.23),各组间差异显著。3组的平均促性腺激素释放激素激动剂(GnRH-a)用量无显著差异[(2 587±919)和(2 652±1 131),(2 498±1 111)IU],但短方案组和拮抗剂组的平均Gn天数[(10.01±2.19)和(9.88±2.06)d]及卵巢过度刺激综合征(OHSS)发生率(1.49%,0)均显著低于长方案组[(10.79±1.62)d;6.68%]。胚胎发育方面,3组的受精率、卵裂率、两原核(2PN)受精率、2PN卵裂率和异常受精率均无显著差异。长方案组和拮抗剂组的可利用胚胎率(47.56%和48.75%)显著低于短方案组(56.77%)。妊娠结局方面,3组方案的临床妊娠率(44.03%,42.86%,39.29%)、生化妊娠率(12.50%,11.43%,3.57%)和胚胎种植率(28.46%,27.66%,25.81%)均无统计学差异(P>0.05)。结论:长方案、短方案和拮抗剂方案具有相似的妊娠结局,但后两者的OHSS发生率显著低于长方案

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