比较HMG、基因重组促卵泡素组合拮抗剂方案对卵巢低反应体外受精结局影响

目的探讨促性腺激素释放激素拮抗剂（GnRH拮抗剂）分别配伍HMG与基因重组促卵泡素方案对卵巢低反应患者控制性超排卵的效果，并比较两种不同组合对体外受精一胚胎移植结局是否存在差异。方法纳入研究对象为前次IVF—ET治疗失败，证明是卵巢低反应，要求再次IVF—ET治疗的患者，随机分为2组，A组使用GnRH拮抗剂＋HMG方案．共40周期，B组使用GnRH拮抗剂＋果纳芬，共40个周期。将两组患者的年龄、不孕年限、不孕类型、不孕原因、基础FSH水平、周期取消率、hCG日血清E2水平、LH水平、受精方式、自然流产率、临床妊娠率、胚胎种植率等进行比较。结果两组患者年龄、不孕年限、不孕类型、不孕原因、基础FSH水平、受精方式、周期取消率、自然流产率等比较差异均无显著性（P〉0．05）。两组患者的hCG日血清E2水平、LH水平、临床妊娠率、胚胎种植率等比较差异均有显著性（P〈0．05），上述指标以GnRH拮抗剂＋HMG组为高。结论GnRH拮抗剂与HMG配伍，对卵巢低反应的患者是一种有效的超排卵治疗方案，与GnRH拮抗剂与基因重组促卵泡素组合相比，可以提高IVF—ET的临床妊娠率和胚胎种植率，并且费用低廉。

The comparison of HMG, gene Recombinant Follicle- stimulating hormone respectively uniting GnRH -A project on vitro fertilization outcome in poor ovarian responser.

Objective ： To study the effect of super ovulation controlling with Gonadotropin - releasing hormone antagonists （ GnRH antagonists） respectively uniting HMG and gene recombinant follicle -stimulating hormone in poor ovarian response patients, and to compare the two different combinations of in vitro fertilization and embryo transplantation outcome if there is a difference. Methods ： 80 patients who have been proved Poor Ovarian Responser in the previous IVF - ET treatment, then request again IVF - ET, were randomly divided into 2 groups, groupA, the use of GnRH antagonists unite HMG group project, A total of 40 cycles, group B, the use of Gn- RH antagonists unite gonal -F, A total of 40 cycles. Two group of patient＇s age, years of infertility, types of infertility, reason of infertility, basic level of FSH, cycle cancellation rate, the serum level of E2, LH on hCG day, spontaneous abortion rate, clinical pregnancy rates and embryo cultivation rate were to compare. Results： Two groups of patient＇s age, duration and type of infertility, infertility reason, basic level of FSH, cycle cancellation rate, Fertilization way, spontaneous abortion rate, no significant difference were observed in the comparison （ P 〉 0. 05 ）. Two groups of serum E2, LH levels on hCG day , embryo planting rate, clinical pregnancy rates arc significant differences （ P 〈 0. 05）, the above indexes in GnRH antagonists uniting HMG group is high. Conclusion ： GnRH antagonists uniting HMG is an effective super ovulation treatment plan on low ovary responser, it can improve the clinical pregnancy and embryo cultivation rate of IVF -ET, meanwhile, it is low cost, comparing with GnRH antagonists uniting gene recombinant follicle - stimulating hormone combination.