摘要
目的 研究对比不同促排卵方案在多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)中的应用效果。方法 选择2019年1月至2020年12月于本院就诊的120例PCOS患者为研究对象,根据促排卵方案不同将其分为A组(n=60)和B组(n=60),其中A组采用长效长方案,B组采用拮抗剂方案。观察比较两组患者的妊娠结局、药物使用情况、排卵及胚胎移植情况、子宫内膜厚度以及卵巢过度刺激综合症(OHSS)发生率。结果 A组患者的生化妊娠率和临床妊娠率均高于B组(χ^(2)值分别是4.302、4.089,P<0.05),但早期流产率的差异无统计学意义(χ^(2)=0.134,P>0.05)。A组患者的促性腺激素药物总用量高于B组,用药时长久于B组(t值分别是2.454、3.959,P<0.05)。两组患者的获卵数、优质胚胎数、胚胎受精率及平均移植胚胎数间无统计学差异(t值分别是0.447、0.472、1.183、0.274,P>0.05)。A组患者启动hCG扳机当日子宫内膜厚度厚于B组子宫内膜厚度(t=5.200,P<0.05);A组患者OHSS总发生率高于B组(χ^(2)=4.658,P<0.05)。结论 长效长方案和拮抗剂方案的促排卵效果相近,在接受鲜胚移植的前提下,长效长方案的妊娠成功率更高,患者子宫内膜容受性表现更好;而拮抗剂方案能够减少促性腺激素药物的用量,可有效减少OHSS的发生,安全性更高。
Objective To compare the application effects of different ovulation induction methods on in vitro fertilization-embryo transfer(IVF-ET) in patients with polycystic ovary syndrome(PCOS).Methods A total of 120 patients with PCOS treated in this hospital between January 2019 and December 2020 were enrolled as subjects.According to different ovulation induction methods, they were divided into the group A(n=60) and the group B(n=60).The group A was treated with the long-acting and long-term plan, and the group B was treated with the antagonist plan.The pregnancy outcomes, drugs usage, ovulation and embryo transfer, endometrial thickness and the incidence of ovarian hyperstimulation syndrome(OHSS) in the two groups were observed and compared.Results The biochemical and clinical pregnancy rates in the group A were both higher than those in the group B(χ^(2)=4.302 and 4.089,respectively, P<0.05),while there was no significant difference in early abortion rate between the two groups(χ^(2)=0.134,P>0.05).The total dosage of gonadotropin in the group A was higher than that in the group B,and the medication time was longer than that in the group B(t=2.454 and 3.959,respectively, P<0.05).There were no significant differences in the number of retrieved oocytes and high-quality embryos, fertilization rate of embryo and average number of transferred embryos between the two groups(t=0.447,0.472,1.183 and 0.274,respectively, P>0.05).On the day when hCG trigger was started, endometrial thickness in the group A was thicker than that in the group B(t=5.200,P<0.05).The total incidence of OHSS in the group A was higher than that in the group B(χ^(2)=4.658,P<0.05).Conclusion The ovulation induction effects of long-acting and long-term plan and antagonist plan are similar.Under the premise of fresh embryo transfer, pregnancy success rate of long-acting and long-term plan is higher and endometrial receptivity is better.However, antagonist plan can reduce the dosage of gonadotropin, effectively reduce the incidence of OHSS,and has higher safety.
作者
付正
刘玲
黄华英
杨敏
FU Zheng;LIU Ling;HUANG Huaying;YANG Min(Department of Reproductive Medicine,Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China;Department of Obstetrics,Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China)
出处
《中国妇幼健康研究》
2022年第4期98-103,共6页
Chinese Journal of Woman and Child Health Research
基金
西南医科大学关于公布2017年校级教育教学改革研究项目(JG2017052)。
关键词
促排卵方案
长效长方案
拮抗剂方案
体外受精-胚胎移植
妊娠结局
ovulation induction method
long-acting and long-term plan
antagonist plan
in vitro fertilization-embryo transfer
pregnancy outcomes
