164例卵巢低反应患者体外受精治疗促排卵方案分析

目的：分析按博洛尼亚标准诊断为卵巢低反应（POR）患者的临床特点及不同超促排卵方案的临床结局，探讨适合POR患者的临床治疗方案。方法：回顾性分析2010年12月—2012年10月接受体外受精-胚胎移植（IVF-ET）助孕且诊断为POR的患者164例共186个周期。按治疗方案分为长效长方案组（86个周期）、短方案组（41个周期）和微刺激组（59个周期），分析患者临床特点及不同超促排卵方案的临床结局。结果：164例患者中，年龄＜40岁者112例（68.3%），子宫内膜异位症21例（12.8%），盆腔结核5例（3%），曾有盆腔手术史者28例（17.1%）。微刺激方案组Gn使用时间、Gn用量显著低于长效长方案及短方案组（P＜0.05）；获卵数低于长效长方案组，胚胎冷冻率高于长效长方案组，差异有统计学意义（均P＜0.05），但与短方案组比较差异无统计学意义（均P＞0.05）。结论：微刺激方案是POR患者较理想的超促排卵方案。

Different Ovarian Stimulation Protocols in 164 Patients with Poor Ovarian Response

Objective: To analyse the clinical characteristics of those patients with poor ovarian response（POR） diagnosed according to the Bologna Criteria in IVF-ET, and compare the clinical outcomes of different ovarian stimulation protocols, so as to evaluate therapeutic schedules for POR patients. Methods：The clinical data of 186 cycles in 164 patients undergone IVF-ET in our center from December 2010 to October 2012 were retrospectively analyzed. Those cycles were divided into 3 groups according to ovarian stimulation protocols: the long GnRHa protocol group（186 cycles）, the short GnRHa protocol group （41 cycles） and the mini-stimulation protocol group（59 cycles）. The clinical characteristics and outcomes were compared among three groups. Results：In 164 patients, 112 patients（６８．３％） were aged ＜40, 21 cases （１２．８％） suffered from endometriosis and 5 cases （３％） pelvic tuberculosis, while 28 cases （１７．１％） had the pelvic operation history. The days and the amounts of Gn in the mini-stimulation protocol group were significantly less than those in other two groups （Ｐ＜０．０５）. The mean number of collected oocytes in the mini-stimulation protocol group was significantly lower than that in the long GnRHa protocol group, and the rate of frozen embryos was significantly higher（both P＜0.05）; but there were not significant differences between the mini-stimulation protocol group and the short GnRHa protocol group（both P＞0.05）. Conclusions：The mini-stimulation protocol is an preferable option for POR patients.