控制性超促排卵过程中血清LH低于正常时添加rLH或hMG的效果比较

目的:比较控制性超促排卵(COH)过程中血清促黄体生成素(LH)低于正常时添加基因重组LH(rLH)或人绝经期尿促性腺激素(hMG)的效果。方法:选取因输卵管因素不孕行常规IVF-ET患者85例,全部采用长方案超促排卵,均给予基因重组促卵泡激素(rFSH)进行超促排卵,超促排卵第6日时如血清LH≥1.2 mIU/ml,继续用rFSH,作为对照组(rFSH组,n=37);如血清LH<1.2 mIU/ml,则随机纳入到hMG组(rFSH+hMG,n=30)或rLH组(rFSH+rLH,n=18)。结果:3组间在促性腺激素(Gn)用量、COH天数、获卵数、双原核率、优质胚胎率、临床妊娠率方面均无统计学差异。hMG组的rFSH用量显著低于rLH组(P<0.01)。结论:在黄体期降调节长方案超促排卵第6日,如血清LH<1.2 mIU/ml时,添加hMG或rLH,可获得与对照组(rFSH组)相似的临床结果。与添加rLH组相比,添加hMG组降低了rFSH用量,减少了患者的费用。

Effect of rLH or hMG Combined rFSH Administration during COH on IVF Outcomes in the Patients with Subnormal Serum LH

Objective: To evaluate the effect of ovarian stimulation with rFSH+ rLH or rFSH+ LHcontaining gonadotropins(human menopausal gonadotropin,hMG) on IVF outcomes in the patients with lower than 1.2 mIU/ml serum LH.Methods: A total of 85 eligible women were enrolled in this study.As the conventional IVF treatment for tube-peritoneal factors,all patients were first undergoing luteal phase downregulation protocol,the rFSH was used for COH.Thirty-severn women with serum LH≥1.2 mIU/ml on COH day 6 were treated as the control(rFSH group),and went on using rFSH.Fourty-eight patients,with serum LH<1.2 mIU/ml,rolled into the experimental group,they were administered rFSH with exogenous LH [18 case for rLH(rLH group) and 30 cases for hMG(hMG group)].Results: Both rLH+rFSH or hMG+rFSH combination therapy achieved similar clinical outcomes compared with to rFSH group in terms of the dose of gonadotropins,days of COH,rate of 2PN,rate of good-quality embryos and clinical pregnancy rate.However,hMG group was significantly lower than that of rLH group(P<0.01).Conclusion: Both rLH+rFSH and hMG+rFSH administration in the patients with serum LH <1.2 mIU/ml on COH day 6 can achieve the same IVF clinical outcomes as rFSH group,hMG administration has advantages in reducing the doses of rFSH and therefore could reduce the costs for patients.