摘要
目的 探讨微刺激促排卵方案在卵巢低反应(POR)患者IVF/ICSI-ET中的临床应用价值。方法 回顾性分析2016年1月至2017年12月在我院生殖中心行IVF/ICSI-ET治疗,1年内分别行微刺激方案与其他常规方案促排卵的102例患者。并根据患者不同情况分为两组:预期POR组(70例),未预期POR组(32例)。对每例患者前后不同促排方案治疗周期的临床数据及结果进行分析。结果 预期POR组中,微刺激周期与其他常规促排卵周期比较,HCG日E2水平、获卵数、MⅡ卵数、2PN数、优胚数、可利用胚胎数以及优胚率、可利用胚胎率的组间差异均无统计学意义(P>0.05);Gn天数[(8.59±2.52)vs.(10.72±2.57)d]、Gn总量[(2007.42±930.22)vs.(3276.56±1309.50)U]显著降低,且MⅡ卵率(72.15%vs.57.33%)、正常受精率(68.95%vs.59.48%)显著升高,差异均有统计学意义(P<0.05)。未预期POR组中,微刺激周期与其他常规促排卵周期比较,Gn天数[(9.03±1.26)vs.(11.72±2.44)d]、Gn总量[(1863.28±314.24)vs.(3160.55±1216.86)U]显著降低,差异均有统计学意义(P<0.05);HCG日E2水平、获卵数、MⅡ卵数、2PN数、优胚数、可利用胚胎数以及MⅡ卵率、正常受精率、优胚率、可利用胚胎率比较,差异均无统计学意义(P>0.05)。结论 对于预期的POR患者,微刺激方案可以获得较高的MⅡ卵率和正常受精率;而对于未预期的POR患者,微刺激方案可以减少Gn的用量和天数,但并不能改善其助孕结局。
Objective : To explore the clinical application value of mild stimulation ovulation induction for patients with poor ovarian response (POR) in IVF/ICSI-ET. Methods : The data of 102 patients undergone IVF/ICSI-ET in Department ART of our hospital from January 2016 to December 2017 were retrospectively analyzed. The patients were respectively treated with mild ovarian stimulation protocol and conventional stimulation protocol in one year.The patients were divided into two groups:expected POR group ( n =70),unexpected POR group ( n =32). The clinical data and results of the two groups were compared. Results : In the expected POR group,there were no significant differences in E 2 1evels on the HCG day,number of oocytes retrieved,MⅡ oocytes,normal fertilized oocytes,good quality embryos,available embryos and good quality embryo rate,available embryo rate between mild ovarian stimulation cycles and convention stimulation cycles( P >0.05). The duration [(8.59±2.52) vs.(10.72±2.57)days)] and the total dosage [(2 007.42±930.22)vs.(3 276.56±1 309.50)U] of gonadotropin (Gn) used in mild ovarian stimulation cycles were significantly less than those in convention stimulation cycles ( P <0.05). The MⅡ oocyte rate (72.15% vs. 57.33%)and normal fertilization rate (68.95% vs. 59.48%)in mild ovarian stimulation cycles were significantly higher than those in convention stimulation cycles ( P <0.05). In the unexpected POR group,there were no significant differences in E 2 1evels on the HCG day,number of oocytes retrieved,MⅡ oocytes, normal fertilized oocytes,good quality embryos,available embryos and MⅡ oocyte rate,normal fertilization rate,good quality embryo rate, available embryo rate between mild ovarian stimulation cycles and convention stimulation cycles( P >0.05). The duration [(9.03±1.26)vs.(11.72±2.44)days] and the total dosage [(1 863.28±314.24) vs.(3 160.55±1 216.86)U] of Gn used in mild ovarian stimulation cycles were significantly less than those in convention stimulation cycles ( P <0.05). Conclusions : Mild ovarian stimulation protocol can obtain higher MⅡ rate and normal fertilization rate in the patients with expected POR. For the patients with unexpected POR,mild stimulation ovulation can reduce the duration and the total dosage of Gn used,while cannot improve the outcome of IVF/ICSI-ET.
作者
莫莉菁
付伟平
朱琴
王丽萍
MO Li-jing;FU Wei-ping;ZHU Qin;WANG Li-ping(Reproductive Medical Center,Children and Women Hospital of Jiaxing City,Jiaxing 314000)
出处
《生殖医学杂志》
CAS
2019年第6期649-654,共6页
Journal of Reproductive Medicine
关键词
微刺激
卵巢低反应
卵巢储备功能减退
Mild stimulation
Ovarian response
Diminished ovarian reserve
