Comparison between a GnRH Agonist and a GnRH Antagonist Protocol for the Same Patient Undergoing IVF

In order to compare GnRH agonist with antagonist protocol for the same patient during controlled ovarian stimulation cycles, the in vitro fertilization and embryo transfer （IVF-ET） outcome was retrospectively studied in 81 patients undergoing 105 agonist protocols and 88 antagonist protocols. The results showed that there was no statistically significant difference in duration of ovarian stimulation, number of ampoules, oocytes retrieved, serum estradiol （E2） and progesterone （P） levels, thickness of endometrium, the zygote- and blastocyst-development rate between GnRH agonist and antagonist protocols （P〉0.05）. High quality embryo rate was higher in antagonist protocols, but there was no significant difference between two protocols. Implantation rate and clinical pregnant rate were significantly higher in antagonist protocol （15.82% and 30.26%, respectively） than in agonist protocol （5.26% and 10.64% respectively （P〈0.05）. It was concluded GnRH antagonist protocol probably improved the outcome of pregnancy of older patients with a history of multiple failure of IVF-ET in a GnRH protocol.     

Effects of Growth Hormone Supplementation in Patients Undergoing IVF/ICSI-ET with Poor Ovarian Response to Gonadotropin

Objective To analyze the effects of growth hormone （GH） supplementation during IVF/ ICSI-ET in Chinese patients who had prior IVF cycle with poor response to gonadot- ropin （Gn）. Methods Ovulation was stimulated in 389 consecutive patients who all had poor ovarian response, among them, 102 patients （GH cycle） received 4 IU GH and the other 287 patients （non-GH cycle） underwent IVF without GH. Fisher＇s exact test, Chi square test and Student＇s t-test were used to analyze IVF/ICSI-ET outcomes. Results After GH treatment, 102 patients had significantly more large- and medium- sized follicles, oocytes retrieved, 2 pronucleus oocytes, metaphase H stage （M~I） oocytes, and high-quality embryos than in previous cycles without GH. However, the number of embryos transferred, clinical pregnancy rate, transfer rate and biochemical pregnancy rate were not significantly different. Furthermore, the 102 patients given GH had significantly lower luteinizing hormone levels and biochemical pregnancy rates; thicker endometrium and more Gn administration days; and more large- and medium-sized follicles and M~I oocytes than 287 other patients undergoing IVF/ICSI-ET without GH. However, these groups did not differ significantly in clinical pregnancies, high-quality embryos, Mn oocytes, and embryo implantation rates. Conclusion GH may improve some IVF/ICSI-ET outcomes for women with poor ovarian response.     

促性腺激素释放素拮抗剂联合人重组促黄体激素对卵巢功能减退患者妊娠结局的影响

目的:研究重组人促黄体激素(r-hLH)在促性腺激素释放素(GnRH)拮抗剂促排卵方案中的应用指征?方法:回顾性分析2007年8月至2010年8月在本中心以GnRH拮抗剂方案促排卵的体外受精(IVF/ICSI)患者?卵巢功能减退纳入标准为卵泡刺激数(FSH)≥10U/L或窦卵泡数≤6个?研究分为两部分,第一部分纳入卵巢功能减退患者共107例,A组不添加r-hLH(n = 80),B组添加r-hLH 75 U/d(n = 27)?第二部分纳入应用GnRH拮抗剂+r-hLH+GnRH激动剂扳机的患者共71例并分为两组,C组为卵巢功能正常组(n = 47),D组为卵巢功能减退组(n = 24)?评价两组卵巢反应和妊娠结局的临床指标包括成熟卵子数?受精率?卵裂率?优质胚胎率?种植率和临床妊娠率?结果:①卵巢功能减退患者中,添加r-hLH组每优势卵泡平均雌激素水平?IVF成熟卵子数(100.00% vs 96.31%)显著高于对照组,种植率(29.41% vs 19.46%)和临床妊娠率(44.44% vs 31.25%)均高于对照组,但差异无显著性?②添加了r-hLH的患者中,卵巢功能减退组IVF成熟卵子数(100.00% vs 93.71%)?IVF受精率(79.52% vs 38.46%)和ICSI受精率(84.85% vs 42.74%)显著高于卵巢功能正常组,种植率(28.89% vs 17.44%)?临床妊娠率(41.67% vs 25.53%)均高于卵巢功能正常组,但差异无显著性?结论:在GnRH拮抗剂方案中,添加r-hLH可以改善卵巢反应减退患者的卵巢反应和临床结局?卵巢功能正常者不是添加r-hLH的适应人群?     

Revised Super-long Down-regulation Protocol Improves the Outcome of Infertile Patients with Repeated Implantation Failure in IVF/ICSI-ET

Objective To investigate the outcome of revised super-long down-regulation protocol （RSDP） for in vitro fertilization / intracytoplasmic sperm injection-embryo transfer （1VF/1CS1-ET） in the special infertile patients with repeated implantation failure （RIF）. Methods Patients with RIF were divided into RSDP group and routine long downregulation protocol （RLDP） group. In RSDP group, gonadotropin releasing hormone agonist （GnRHa） was injected intramuscularly by 2.5 mg in mid-luteal phase for the ftrst time and 1.25 mg after 28 d; gonadotropin （Gn） was started 14 d later after the second GnRHa dose. IVF/ICSI-ET was performed according to the routine procedure. The clinical outcomes of RSDP group were compared with those of RLDP group. Results In RSDP group, the number of retrieved oocytes and valid embryos was significantly lower （P〈0.05）; there were no significant differences about fertilization rate （P〉0. 05）; both good-quality embryo rate and implantation rate were significantly increased （P〈0. 005）; clinical pregnancy rate was obviously improved （P〈0. 05）, as compared with RLDP group.Conclusion RSDP can improve the IVF outcomes significantly in RIF patients.     

GnRH拮抗剂方案与GnRH-a长方案对胚胎质量的影响及IVF-ET结局的比较

目的:探讨促性腺激素释放激素拮抗剂（GnRH-ant）方案与促性腺激素释放激素激动剂（GnRH-a）长方案对胚胎质量的影响及体外受精-胚胎移植（IVF-ET）助孕结局的差别。方法:回顾性分析124例接受GnRH-ant方案和477例接受GnRH-a长方案IVF-ET治疗并行新鲜周期移植的患者资料。结果:GnRH-ant方案组Gn天数和Gn用量少于GnRH-a长方案组,差异有统计学意义（P <0.05）。GnRH-a长方案组扳机日雌二醇（E₂）水平高于GnRH-ant方案组,差异有统计学意义（P <0.05）。两组间扳机日卵泡数、≥14 mm卵泡数、孕酮（P）、子宫内膜厚度、获卵数、正常受精数、正常卵裂数、优胚数和可用胚胎数之间差异无统计学意义（P >0.05）。GnRH-ant方案组生化妊娠率及临床妊娠率均高于GnRH-a长方案组,但差异无统计学意义（P >0.05）。结论:GnRH-ant方案可能对胚胎质量无影响。两组间IVF-ET结局无差异,但GnRH-ant方案Gn天数和Gn用量较少,并倾向获得更高的生化妊娠率及临床妊娠率。     

比较GnRH激动剂长方案与GnRH拮抗剂方案对LH/FSH比值大于等于2的多囊卵巢综合征患者临床结局影响

目的:探讨促性腺激素释放激素（GnRH）激动剂长方案与GnRH拮抗剂方案对LH/FSH比值大于等于2的多囊卵巢综合征（ PCOS）患者胎质量影响及助孕结局的差别。方法:回顾性分析本中心多囊卵巢综合征患者行体外受精-胚胎移植（IVF-ET）,将月经第3天LH/FSH比值为2设为临界值分为比值升高组（58个周期）和比值未升高组（248个周期）,分析比较两组基础临床资料,再分别根据不同促排卵方案分为GnRH激动剂长方案与GnRH拮抗剂方案组,根据LH/FSH的比值不同探讨不同促排卵方案对PCOS患者胚胎质量及妊娠结局的影响。结果:首次分组,LH/FSH≥2组Gn总量少于LH/FSH<2组（P<0.05）,胚胎质量及临床结局无统计学差异（P>0.05）;再次分组,在LH/FSH≥2前提下应用GnRH拮抗剂方案组促性腺激素（Gn）总量、Gn总天数少于GnRH激动剂长方案组（P<0.05）,获卵数、正常受精数、正常卵裂数、优胚数均优于GnRH激动剂长方案组（P<0.05）。结论:PCOS患者中月经第3天LH/FSH比值以2为临界值可能对胚胎质量及临床结局无显著影响,LH/FSH临界值≥2的PCOS患者应用GnRH拮抗剂方案临床结局明显优于GnRH激动剂长方案。     

IVF/ICSI长方案中是否采用口服避孕药预处理的结果比较

目的探讨口服避孕药(OC)预处理在有自发排卵的不孕患者体外受精/单精子卵胞浆内显微注射(IVF/IC-SI)长方案中的价值。方法回顾性分析1 668个新鲜周期,并根据降调前是否用OC预处理分为2组:A组为在长方案降调之前使用OC预处理组,B组为降调前未使用OC组。比较两组之间各参数及结局。结果两组促性腺激素(Gn)用量及刺激天数、获卵数、受精率、卵裂率、妊娠率、流产率、反应不良取消周期率、功能性囊肿发生率均无统计学差异。但A组降调后血清雌激素(E2)值及HCG注射日内膜值低于B组,HCG日E2值以及因有卵巢过度刺激综合征(OHSS)风险取消新鲜周期移植的概率高于B组;35岁以上患者降调后激素水平及HCG日内膜值均低于B组,Gn用量大于B组。结论使用OC预处理并不能降低功能性囊肿的发生率或者提高妊娠率,而且可能导致垂体抑制过度,在年龄偏大的患者中表现尤其明显。     

垂体降调节后延迟卵巢启动时间对体外受精-胚胎移植结局的影响

目的 探讨体外受精-胚胎移植(IVF-ET)中应用半量长效促性腺激素释放激素激动剂(GnRHa)降调节后,延迟超促排卵(COH)启动时间对实验室和临床结局等的影响.方法 将IVF中207个周期分为对照、常规和延迟组:对照组98周期于黄体中期予短效GnRHa 0.1 mg/d,月经第3 d减半,常规组63周期和延迟组46周期于黄体中期予长效GnRHa 1.87 mg;对照组和常规组于月经第3 d加用促性腺激素(Gn),延迟组于第7 d加用Gn,观察在IVF-ET中临床和实验室的结局是否有差异.结果 常规组的取消周期数最多(P＜0.01).COH启动日,延迟组和对照组E2、LH水平高于常规组(P均＜0.01).HCG注射日,对照组的E2水平最高;延迟组和对照组中LH水平高于常规组(P均＜0.01),刺激天数和Gn用量少于常规组(P均＜0.005),获卵数、受精率、可移植胚胎数、临床妊娠率、胚胎种植率和MⅡ期卵子高于常规组(P均＜0.05);延迟组中重度卵巢过度刺激综合征(OHSS)的发生少于常规组.结论 延迟COH启动时间可减少卵巢刺激时间、Gn用量,增加获卵数、成熟卵子数、可移植胚胎数和胚胎种植率,提高IVF的妊娠率.     

小卵泡穿刺联合GnRH拮抗剂在PCOS患者的IVF-ET效果分析

目的 探讨超促排卵过程中经阴道超声下小卵泡穿刺联合GnRH拮抗剂对多囊卵巢综合征（PCOS）患者的疗效。方法 选取2013年6月~2016年6月在笔者中心行体外受精-胚胎移植（IVF-ET）超促排卵过程中卵泡发育数量过多的PCOS患者139例141周期,其中实验组（小卵泡穿刺联合GnRH拮抗剂）60例62个周期,对照组79例79个周期（按临床常规减量Gn或卵泡成熟日根据E₂水平行coasting治疗）。比较两组的一般情况、日Gn最大量、Gn使用天数、Gn总用量、获卵数、成熟率、受精率、卵裂率以及OHSS发生率、取消移植率、临床妊娠率等数据。结果 两组患者的年龄、体重指数、不孕年限以及基础内分泌差异无统计学意义（P均>0.05）。实验组日Gn最大量较对照组显著减少（P<0.01）,实验组的Gn天数、扳机日E₂水平和扳机日 ≥ 10mm卵泡个数减少,较对照组差异有统计学意义（P均<0.05）,实验组获卵数较对照组显著减少（P=0.000）。实验组的卵子成熟率和优胚率较对照组显著增加（P均<0.01）。实验组的中重度OHSS发生率和取消移植率显著减少（P均<0.01）,实验组的临床妊娠率和持续妊娠率较对照组增加,差异有统计学意义（P均<0.05）。结论 经阴道超声下小卵泡穿刺联合GnRH拮抗剂是一种有效解决PCOS患者超促排卵过程中过多卵泡发育问题的手段,可以显著降低中重度OHSS的发生率,改善卵子成熟率和优胚率,提高IVF-ET的临床结局。     

Outcome of the IVF for the Patients with Endometrioma Associated Infertility

Objective To evaluate the ovarian response to the gonadotrophin （Gn） in the COH and observe the outcome of lVF for the patients with endometriomas. Methods A retrospective analysis of 32 patients with endometrioma undergoing IVFET. It included 71 cycles, and 59 cycles in 32 patients with tubal factor associated infertility were as the control. Results There were statistically significant differences between the two groups in the cancelling rate （P〈0.01）, the E： concentration in the day of hCG injection （P〈0.05）, retrieval eggs（P〈0.001）, rate of fertilization （P〈0.05）, rate of cleavage （P〈0.05）, obtained embryos （P〈0. 001）. There were no statistically significant differences in the clinical pregnancy rate, implantation rate and delivery rate, P all〉0.05. Conclusion The patients with endometriomas had a poor response to the Gn in the COH. The endometrial accessibility in patients with endometriomas seemed not to be affected by the presence of endometriomas. But considering the higher cancelling rate, the prognostic for the patients with endometriomas was worth than the patients with tubal factor associated infertility.     

The Younger the Patients the Less Adverse Effect of Diminished Oocyte Reserve on Outcome Following in vitro Fertilization -embryo Transfer as Long as the Proper Ovarian Stimulation Protocol is Used

Objective To determine the confounding effect of oocyte reserve and age on pregnancy rates per oocyte retrieval and a comparison of the average number of babies born from a given oocyte harvest. Methods In vitro fertilization-embryo transfer （IVF-ET） cycles were retrospectively reviewed over a l O-year period They were stratified according to whether they had normal oocyte reserve （day 3 serum FSH 〈12 mlU/ml and serum estradiol 〈50 pg/ml） or diminished oocyte reserve. Mild stimulation was used if low oocyte reserve. The pregnancy rate per retrieval included all pregnancies （fresh or frozen embryo transfer） resulting from one retrieval. The average number of babies born was also compared according to reserve. Results For the diminished oocyte reserve group, the live delivered pregnancy rates per transfer were 80% as good in women aged 〈35 years, 70% as good in women 3639 years, but only 43% as good as women aged 40-42 years. However, because of more total embryos the pregnancy rate per given oocyte retrieval was only 55% as good for women with diminished oocyte reserve aged 〈39 years. The average number of babies born per retrieval was twice as high as those with normal reserve for this age group. Conclusion The use of mild follicle stimulating hormone （FSH） stimulation allows a live delivered pregnancy rate per transfer that is 75% as good for women aged 〈39 years but because of less embryos a likelihood of pregnancy rate per retrieval only half as good as women with normal reserve.     

Improved Prediction of In Vitro Fertilization Clinical Out- comes by Combining Ultrasound,Serum Hormones and Body Mass Index

Objective To identify efficient predictors of clinical outcomes of in vitro fertilization(IVF).Methods Two hundred and one women undergoing their first IVF cycle were measured for antral follicle count(AFC) and endometrial thickness via ultrasound. On day 2 or3 of the menstrual cycle and the day of human chorionic gonadotropin administration,serum levels of follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol,and progesterone were determined. The difference of ovarian response and clinical pregnancy rates were measured.Results Basal FSH was the single best predictor of ovarian response in women 35years old before the initiation of treatment, with an area under the receiver operating characteristic curve(AUC) of 0.752. For women ≥35 years old, none of parameters was a single good predictor of IVF pregnancy. For women older than 35 years, adding body mass index(BMI) with AFC and basal FSH improved prediction of ovarian response(AUC=0.859). Prediction of clinical pregnancy for women ≥ 35 years was improved either by combining only AFC and basal FSH(AUC=0.757) or adding BMI to the combined AFC and FSH(AUC=0.722).Conclusion Combining AFC, basal FSH, and BMI was the best predictor of ovarian response and clinical pregnancy after IVF in women ≥35 years.     

Successful Pregnancy and Delivery after Multifetal Pregnancy Reduction in AWoman with Monochorionic Triplet Pregnancy Following Intracytoplasmic Sperm Injection and the Transfer of Frozen-thawed Embryos

This was the first report of multifetal pregnancy reduction （MFPR） with mono- chorionic triplet pregnancy following ICSI and the transfer of frozen-thawed embryos. A 30-year-old woman who had undergone ICSI and the transfer of frozen-thawed embryos subsequently developed monochorionic triplet pregnancy. She did a multifetal pregnancy reduction to remove one embryo limb from the fetal sac and remained a singleton pregnancy after pregnancy reduction. At last she delivered a healthy baby girl at 40 weeks of gestation. In conclusions, an early stage fetal reduction, selection of the appropriate reduction week, and the expertise of a highly experienced doctor using ultrasound can ensure a wonderful pregnancy outcome in monozygotic multiple pregnancies.     

高龄IVF患者应用黄体期促排卵方案与GnRH-a超短方案的助孕结局比较

目的观察黄体期促排卵方案与GnRH-a 超短方案在行体外受精- 胚胎移植（IVF-ET）助孕高龄患者中的应用,探讨黄体期促排卵方案的有效性及可行性。方法对114例高龄患者161个IVF-ET周期过程及结局进行回顾性分析,其中,GnRH-a 超短方案83 例（A 组）、黄体期促排卵方案31 例（B 组）,比较两种方案的促排卵效果及妊娠结局。结果与A组相比,B组人绝经期促性腺激素用量较多、重组促卵泡激素用量较少、促性腺激素（Gn）用量较多、Gn费用较少及受精率较高,优质胚胎率较低,组间比较,差异有统计学意义（P <0.05）。两组患者在年龄、不孕年限、体重指数、基础卵泡刺激素、基础黄体生成素、基础雌二醇、Gn天数、扳机日雌二醇水平、平均获卵数、2PN、可利用胚胎数、可移植胚胎率、临床妊娠率及早期流产率等方面比较,差异无统计学意义（P >0.05）。结论对于高龄患者,黄体期促排卵方案与GnRH-a 超短方案相比,在Gn费用较少的情况下有较高的受精率,且两组在总获卵数、可利用胚胎率及妊娠结局等方面比较,差异无统计学意义（P >0.05）,提示黄体期促排卵方案可作为高龄IVF患者理想的治疗方案。     

左五合方对卵巢低反应者IVF/ICSI-ET助孕结局的影响

目的?评价左五合方对卵巢低反应（POR）者体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)卵巢反应性、妊娠相关指标的影响。方法?将100例肾精不足合脾气虚型POR患者随机分为治疗组和对照组各50例,2组均常规行IVF/ICSI-ET,其中治疗组以左五合方治疗3月再行IVF/ICSI-ET。比较2组患者促性腺激素（Gn）用量及用药天数、人绒毛膜促性腺激素（HCG）注射日雌二醇（E₂）及孕酮（P）水平、获卵数、优胚率、生化妊娠率、临床妊娠率、持续妊娠率。结果?2组Gn用量及用药天数、HCG日E₂和P水平、优胚率、生化妊娠率差异均无统计学意义（P>0.05）;治疗组获卵数、临床妊娠率、持续妊娠率均高于对照组（P<0.05）。结论?左五合方能提高POR者IVF/ICSI-ET的获卵数、临床妊娠率和持续妊娠率。      

何氏养巢方对高龄DOR不孕症患者卵巢功能及IVF结局的影响

[目的]观察何氏养巢方对肾虚型高龄卵巢储备功能减退(diminished ovarian reserve,DOR)不孕症患者卵巢功能及体外人工受精(in vitro fertilization,IVF)结局的影响。[方法]将符合纳入标准的患者随机分为对照组及治疗组各30例,治疗组予何氏养巢方预处理,对照组予脱氢表雄酮(dehydroepiandrosterone,DHEA)胶囊预处理,两组均采用高孕激素状态下促排卵方案(progestin primed ovarian stimulation,PPOS)进行IVF。预处理时间为3个月,观察治疗前后患者的肾虚证候评分、生殖激素水平,IVF周期中促性腺激素(gonadotropin,Gn)使用量及时间、获卵数、成熟卵率、受精数、受精率、卵裂胚胎数、卵裂率、可利用胚胎数、可利用胚胎率、优质胚胎数、优质胚胎率及周期取消率。[结果]何氏养巢方显著改善了高龄DOR不孕症患者的阴虚证候,其与DHEA均能提高血清抗苗勒管激素(anti-Müllerian hormone,AMH)水平,降低促卵泡生成素(follicle stimulating hormone,FSH)水平及促卵泡生成素/黄体生成素(follicle stimulating hormone/luteinizing hormone,FSH/LH)值;何氏养巢方降低FSH水平的效果优于DHEA(P0.05)。治疗组获卵数、成熟卵数、卵裂胚胎数、可利用胚胎数、优质胚胎数均显著优于对照组(P0.05);除成熟卵率外,受精率、卵裂率、可利用胚胎率、优质胚胎率等参数组间比较差异无统计学意义(P0.05)。[结论]何氏养巢方改善了高龄DOR不孕症患者的卵巢功能、卵子质量以及IVF结局,且效果优于DHEA。     

子宫腺肌病对体外受精-胚胎移植临床结局的影响

目的探讨子宫腺肌病对不孕患者体外受精-胚胎移植（IVF/ICSI-ET）临床结局的影响及其可能的原因。方法回顾性分
析南方医院经阴道超声诊断为子宫腺肌病患者61个IVF/ICSI周期作为研究组,对照组为164例单纯输卵管性不孕患者。对两
组的一般情况、控制性促排卵过程中的卵巢反应性、胚胎着床率、临床妊娠率、早期流产率、活产率等进行分析。结果研究组的
新鲜周期胚胎着床率、临床妊娠率、活产率均显著低于对照组（P<0.05）,早期流产率显著高于对照组（P<0.05）。研究组中,与
GnRHa降调节的长方案相比,GnRH拮抗剂方案对临床妊娠率、早期流产率均有不利影响（25.0% vs 45.0%,P=0.184;66.7% vs
27.8%,P=0.247）,但无统计学差异,而活产率显著低于长方案组患者（0% vs 30.8%,P=0.025）。结论子宫腺肌病降低不孕患者
IVF/ICSI-ET的胚胎着床率、临床妊娠率、活产率,且增加流产率,GnRH拮抗剂方案对子宫腺肌病患者IVF/ICSI-ET的临床结局
有负面影响,GnRHa长方案能够增加IVF/ICSI-ET的临床妊娠率、降低流产率。
     

补救ICSI联合人工辅助激活对IVF失败卵母细胞发育影响的研究

目的 探讨常规体外受精(IVF)完全失败的卵母细胞应用补救性单精子卵胞浆内注射(ICSI)联合人工辅助激活方法的临床价值.方法 对常规体外受精完全失败的17枚人卵母细胞进行补救性ICSI并采用7%无水乙醇人工辅助激活处理,于ICSI后的24 h观察卵母细胞的受精情况,于48 h及第5天观察胚胎的分裂及后期发育,并在实施...     

Effect of Long Protocol on the Outcome of In Vitro Fertilization-embryo Transfer in Patients with Endometriosis Compared with Prolonged Protocol

Objective To investigate the effect of different down-regulation protocol on the in vitro fertilization-embryo transfer （IVF-ET） outcomes in infertile patients with endometriosis （EMs）.Methods A retrospective case control study was performed. Totally 294 infertile patients with EMs were enrolled. And 109 patients （116 cycles） received prolongedprotocol as the control, 185 patients （193 cycles） received long protocol as case group, all followed by standard controlled ovarian hyperstimulation （COH）. Response to gonadotropins, the fertilization rate, the cleavage rate, the implantation rate, the clinical pregnancy rate and the miscarriage rate were measured and analyzed between the two groups. Results A trend toward better ovarian response was observed in long protocol group. Higher fertilization rate, lower total dose of rFSH, shorter duration of stimulation and more endometrial thickness on the day of hCG injection were observed in long protocol group compared with those of prolonged protocol group, and the difference was significant （P〈0.05）. In addition, the clinical pregnancy rate, the cleavage rate and the implantation rate also had an increase trend in long protocol group compared with those of prolonged protocol group, but without significant differences. Conclusion Long protocol regimen before IVF-ET in patients with EMs resulted in a trend toward better ovarian response and higher clinical pregnancy rates than prolonged protocol regimen did.     

生长激素对高龄卵巢储备功能低下患者IVF-ET治疗结局的影响

目的探讨GH对高龄卵巢储备功能低下患者在IVF-ET中是否有影响。方法自2010年1月至2011年2月在郑州大学第一附属医院生殖中心行IVF-ET的高龄（年龄≥35岁）卵巢储备功能低下的不孕患者69例,所有患者均在该中心采用普通长方案降调节。结果实验组（应用GH）39例,对照组（未用GH）30例。生长激素（GH）对年龄≥35岁的不孕症患者Gn用量（Gn支数）实验组显著低于对照组,有统计学差异（P〈0.05）;HCG日E2水平、获卵数实验组显著高于对照组,有统计学差异（P〈0.05）。结论生长激素对高龄（年龄≥35岁）卵巢储备功能低下患者的卵巢反应及IVF-ET治疗结局有一定影响,可减少Gn使用量,提高HCG日的E2水平,增加获卵数。