辅助生殖中促排卵药物使用剂量对临床结局的影响

目的探讨辅助生殖治疗中促性腺激素（Gn）用量与临床结局的关系。方法回顾性分析2012年6月～2013年1月在广东省妇幼保健院接受体外受精胚胎移植（IVF—ET）治疗患者的临床资料，共1423个周期。按照Gn用量的不同分为i组（〈1875U）、ii组（1875。〈2250U）、iii组（2250-〈2625U）、iv组（2625～3000U）、v组（〉3000U）来分析Gn用量和临床结局的关系。结果各剂量组总受精率、2PN受精率、种植率比较．差异无统计学意义（P〉0．05）。iv组、v组和i组平均获卵数、生化妊娠率和临床妊娠率比较，差异有统计学意义（P〈O．05），并且平均获卵数随着剂量的增加而增多，而生化妊娠率和临床妊娠率出现下降。结论Gn用量的增大可以提高获卵数，对受精率无明显影响，但是生化妊娠率和临床妊娠率降低．说明过高的Gn用量可能影响卵子的质量，使胚胎继续发育潜能降低，在以后的使用中应控制在合理的范围内，推荐2—3支／d。

Influence of the dosage of ovulation induction during assisted reproduc- tion for clinical outcome

Objective To investigate the relationship of the dose of gonadotropin （Gn） and clinical outcome during the treat- ment of assisted reproduction. Methods The clinical data of patients receiving in vitro fertilization-embryo transfer （IVF-ET） in Guangdong Maternal and Child Health Hospital from June 2012 to January 2013 was analyzed retrospectively, total 1423 IYF-ET cycles. They were divided into five groups according to the different dosages of Gn, which were group i （〈1875 U）, group ii （1875-〈2250 U）, group iii （2250-〈2625 U）, group iv （2625-3000 U）, group V （〉3000 U）, so as to analyze the relationship of the dose of Gn and clinical outcomes. Results There were no statistically significant differences of total fertility rate, 2PN fertilization rate and implantation rate among the five groups with （P 〉 0.05）. The differences of the average number of received ovum, the biochemical pregnancy rate and clinical pregnancy rate in group iv and group V compared with group i were statistically significant different （P 〈 0.05）, in addition, the average number of received ovum got larger with the increase of dosage, while the biochemical pregnancy rate and clinical pregnancy rate were declined. Conclusion The enlargement of Gn dosage can increase the number of received ovum and has no significant influence on fertility rate. However, the decrease of the biochemical pregnancy rate and clinical pregnancy rate shows that exorbitant dosage of Gn may affect the quality of ovum and reduce the potency of embryo development, therefore, the usage should be controlled in reasonable range later, 2-3 vials/d are suggested.