两种卵泡刺激素在多囊卵巢综合征患者体外受精-胚胎移植中疗效比较

目的比较两种不同的卵泡刺激素(FSH)在多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)中的治疗效果。方法回顾性分析2013年1月至2014年12月就诊于我院生殖中心的130例PCOS排卵障碍性不孕患者的IVFET临床资料。根据促排卵方案中的FSH选择分成两组:重组卵泡刺激素(rFSH,果纳芬)和高纯度尿源性卵泡刺激素(uFSH-HP,丽申宝),比较两组患者的Gn总剂量、Gn天数、获卵数、获成熟卵率、2PN率、优胎率、冻胚率、鲜胚妊娠率、冻胚妊娠率、多胎妊娠率、中-重度OHSS发生率及Gn费用等临床资料。结果总Gn剂量、Gn天数、获卵数、2PN率、优胚率、冻胚率、鲜胚移植妊娠率、冻胚移植妊娠率、多胎妊娠率及中-重OHSS发生率组间比较均无统计学差异(P0.05);uFSH-HP组获成熟卵率较rFSH略高(80.80%vs.71.20%),但差异无统计学意义(P0.05);而uFSH-HP组的Gn费用显著低于rFSH组[(6 037±1 569)vs.(9 049±1 332)元](P0.01)。结论 uFSH-HP组取得与rFSH组相似的妊娠结局,但费用更低,可考虑做为PCOS患者的治疗选择。

Comparison of clinical efficacy of two different FSH preparations in IVF-ET cycles in patients with polycystic ovarian syndrome

Objective: To compare the treatment outcomes of two different FSH preparations in IVF-ET for patients with polycystic ovarian syndrome ( PCOS).
Methods: The clinical data of 130 anovulatory infertile women with PCOS undergone IVF-ET in our reproductive center from January 2013 to December 2014 were retrospectively analyzed. According to FSH preparation used for ovulation stimulation, the patients were divided into two groups:recombinant FSH ( rFSH, Gonal-F) group and high purity of urinary FSH ( uFSH-HP,Lishenbao) group. The dose of gonadotropin ( Gn) used,number of oocytes retrieved,the days of Gn used,mature oocyte rate,2PN rate,good embryo rate,frozen embryo rate,fresh embryo pregnancy rate,frozen embryos pregnancy rate,multiple pregnancy rate and severe ovarian hyperstimulation syndrome ( OHSS) incidence and the cost of Gn used.
Results: There were no significant differences in duration of controlled ovarian hyperstimulation ( COH) ,total dose of FSH used,oocytes retrieved rate,2PN rate,good-quality embryos rate,frozen embryos rate,fresh embryo pregnancy rate,frozen embryo pregnancy rate,OHSS incidence and multiple pregnancy rate between two groups ( P>0. 05). The rate of mature oocytes retrieved(80. 80% vs. 71. 20%) in uFSH-HP group was higher than that in rFSH group,but it was not significant (P>0. 05). The cost of Gn used in uFSH-HP group[(6 037±1 569)RMB vs. (9 049±1 332)RMB] was significantly lower than that in rFSH group (P<0. 01).
Conclusions: uFSH-HP can achieve similar COH efficacy and clinical outcomes as rFSH in IVF treatment, but it has an advantage of lower cost.