摘要
目的探讨拮抗剂促排卵方案中添加黄体生成素(luteinizing hormone,LH)对高龄卵巢储备功能减退(diminished ovarian reserve,DOR)患者初次体外受精-胚胎移植(in vitro fertilization embryo transfer,IVF-ET)临床结局的影响。方法选择2019年6月至2020年12月在海南医学院第一附属医院生殖医学中心就诊首次行IVF-ET助孕并符合DOR诊断标准的150例患者。依据是否添加LH将患者分为两组:单用卵泡刺激素(follicle stimulating hormone,FSH)为对照组(86例);促性腺激素释放激素拮抗剂日开始添加LH至绒毛膜促性腺激素日为研究组(64例),收集两组患者的获卵数、2PN受精率、优质胚胎率、着床率、临床妊娠率等并进行分析。结果两组患者的年龄、不孕年限、基础性激素水平、窦卵泡计数、体质量指数和抗苗勒管激素比较,差异均无统计学意义(P>0.05)。两组患者促性腺激素(gonadotropin,Gn)总量,Gn使用时间、扳机日P水平、扳机日子宫内膜厚度和获卵数比较,差异无统计学意义(P>0.05)。研究组患者的2PN受精率、可利用胚胎数和优质胚胎率显著高于对照组(P<0.05),着床率和临床妊娠率优于对照组,差异无统计学意义(P>0.05)。结论对于高龄DOR患者拮抗剂方案促排过程中反向添加LH可能有助于改善卵子质量,改善临床结局。
Objective To investigate the effect of luteinizing hormone(LH)adding for elderly patients with diminished ovarian reserve(DOR)in GnRH antagonist protocol undergoing the first IVF-ET.Methods Total 150 elderly patients who met the diagnostic criteria of DOR from the Reproductive Medicine Center of the First Affiliated Hospital of Hainan Medical College from June 2019 to December 2020 were enrolled in the study.Patients were divided into two groups according to whether LH was added:follicle stimulating hormone(FSH)alone was used as the control group(86 cases),add LH from gonadotropin-releasing hormone antagonist(GnRH-ant)day to chorionic gonadotropin(hCG)day as the study group(64 cases).The pregnancy outcomes such as the number of retrieved oocytes,2 PN fertilization rate,high quality embryo rate,implantation rate and clinical pregnancy rate were analyzed.Results There were no significant differences in age,infertility years,basal hormone level,basal AFC number,body mass index(BMI)and AMH value between the two groups(P>0.05).There were also no significant differences in the total amount of gonadotropin(Gn),the time of Gn,the trigger day of P level,the thickness of endometrium on trigger day and the number of eggs between the two groups(P>0.05).The 2 PN fertilization rate,the number of available embryos and high quality embryos rate in the study group were significantly higher than those in the control group(P<0.05).The implantation rate and clinical pregnancy rate in the study group were higher than those in the control group,but there were no significant difference between the two groups(P>0.05).Conclusion The addition of LH in elderly patients with DOR may improve the quality of eggs and increase the clinical pregnancy rate during GnRH antagonist protocol.
作者
谢宝国
马燕琳
黄元华
Xie Baoguo;Ma Yanlin;Huang Yuanhua(Key Laboratory of Tropical Translation Medicine of Ministry of Education,Hainan Medical University;Hainan Provincial Clinical Research Center for Thalassemia;Hainan Provincial Key Laboratory of Human Reproductive Medicine and Genetic Research;Reproductive Medicine Center,the First Affiliated Hospital of Hainan Medical University,Haikou Hainan 570102,P.R.China)
出处
《中国计划生育和妇产科》
2021年第10期79-81,86,共4页
Chinese Journal of Family Planning & Gynecotokology
基金
海南省卫生计生行业科研项目(项目编号:19A200124)。
关键词
卵巢储备功能减退
拮抗剂方案
黄体生成素
体外受精-胚胎移植
临床妊娠率
diminished ovarian reserve
GnRH antagonist protocol
luteinizing hormone
in vitro fertilization embryo transfer(IVF-ET)
clinical pregnancy rate
