两种垂体降调节长方案用于IVF／ICSI的临床效果分析

目的：探讨不同降调节长方案用于体外受精／卵细胞浆内单精子注射（IVF／ICSI）助孕治疗的临床效果。方法：回顾性分析2011年6月～2013年1月在本中心采用垂体降调节长方案行IVF／ICSI治疗患者的95个周期临床资料。根据不同降调节方案分为两组，其中A组（41个周期）注射曲普瑞林0．1mg／d，7d后改为0．05mg／d至月经第3天促性腺激素（Gn）启动，直至人绒毛膜促性腺激素日（hCG日）；B组（54个周期）注射曲普瑞林0．1mg／d至月经第3天Gn启动后改为0．05mg／d至hCG日。比较两组曲普瑞林使用总量和时间，以及促排卵效果和妊娠情况。结果：A、B两组使用曲普瑞林时间分别为10．95±1．43d和13．17±2．53d，使用曲普瑞林总量分别为1．37±0．11mg和1．69±0．22mg，差异均有统计学意义（P〈0．01））。Gn日和（或）hCG日两组卵泡刺激素（FSH）及雌二醇（E2）、孕酮（P）水平差异无统计学意义（P〉0．05），黄体生成激素（LH）水平在Gn日差异无统计学意义（P〉0．05），在hCG日分别为1．29±0．60U／L、0．934-0．57U／L，差异有统计学意义（P〈0．05）。获卵数及可移植胚胎数和移植胚胎数两组差异均无统计学意义（P〉0．05），临床妊娠率两组差异有统计学意义（40．6％和18．6％，P〈0．01）。结论：两种不同的垂体降调节长方案中，曲普瑞林0．1mg／d，7d后改为0．05mg／d至月经第3天Gn启动的方案临床妊娠率相对较高，用药量较，b．

Clinical effects of two kinds of long down - regulation protocols in IVF/ICSI

Objective ： To explore the application and clinical effects of two different kinds of long down - regulation protocols by short - acting triptorelin in IVF/ICSI. Methods ： Ninety - six cycles of IVF or ICSI were analyzed. According to different doses of short - acting triptorelin, total cycles were divided into two groups. In group A, all the women were received 0.1 mg of triptorelin everyday, and 0.05rag everyday after 7 days until hCG day. In group B, all the women were received 0. ling of triptorelin everyday until hCG day. The gonadotropin was used when the pituitary down regulation was achieved. The doses and duration of triptorelin use, the outcome of IVF/ICSI were compared between two groups. Results ： There were significant differences in the amount and duration of triptorelin use between two groups （ P 〈 0.05 ） , however there were no differences in concentrations of follicle - stimulating hormone, estradiol, progesterone on the Gn and hCG days （ P 〉 0.05 ）. There was sig- nificant difference in the level of luteinizing hormone on the Gn day （ P 〉 0.05 ） , while no significant difference on the hCG day （ P 〈 0.05 ）. There were no statistical differences in numbers of egg retrieval, potential transferred embryo and transferred embryo （P 〉0.05）, while there was significant difference in the clinical pregnancy rate between two groups （40.6% vs. 18.6%, P 〈 0.01 ）. Conclusion： Higher clinical pregnancy rate and less dose of triptorelin used are found in the protocol re- ceived by women in group A.