二甲双胍与促性腺激素协同作用在体外受精胚胎移植周期中的应用

[目的]探讨二甲双胍与促性腺激素协同作用在体外受精胚胎移植(IVF ET)周期中的临床应用.[方法]对空腹胰岛素水平正常、月经周期延长的多囊卵巢(PCO)助孕患者,应用二甲双胍与促性腺激素协同作用进行超排卵治疗,作为实验组;自身前次 IVF ET治疗周期作为对照组,总例数为 32例.[结果]联合应用组 hCG日 HOMA IR和 E2水平、使用促性腺激素(Gn)天数、使用 Gn总量、获卵数,流产率和卵巢过度刺激综合征(OHSS)的发生率均显著低于对照组;卵子的成熟率、受精率、胚胎评分、胚胎种植率、临床妊娠率则显著高于对照组.[结论]应用二甲双胍与促性腺激素协同作用进行超排卵治疗,可以提高 PCO助孕患者的胚胎质量、胚胎种植率及临床妊娠率,降低流产率和 OHSS的发生率.

Application of Metformin in Combination with Gonadotrophin in In Vitro Fertilization-Embryo Transplant(IVF-ET) Cycles

To investigate the clinical application of metformin in combination with gonadotrophin in in vitro fertilization embryo transplant (IVF ET) cycles. Assistant reproductive patients with polycystic ovarium (PCO) who had the normal or a little higher basal insulin level and had normal or lengthened slightly menstrual cyclicity were treated by metformin plus gonadotrophin, and outcome were compared with that treated by gonadotrophin. The indexes in the metformin plus gonadotrophin group were significantly lower than those of the control group such as the homeostasis model assessment estimate of insulin resistance (HOMA IR)and the estradiol level on the day of human chorionic gonadotropin (hCG) administration, the number of days and total dose of gonadotrophin, the number of oocytes, the incidence of spontaneous abortion and ovarian hyperstimulating syndrome (OHSS).Other indexes such as the maturation rate of oocytes, fertilization rate, embryo quality, implantation rate and pregnancy rate in the metformin plus gonadotrophin group was significantly higher than those of the control group. [Conclusion]The study shows that embryo quality, implantation rate, and pregnancy rate are improved, and the incidence of spontaneous abortion and OHSS are reduced for assistant reproductive patients with PCO administrating metformin plus gonadotrophin.