多囊卵巢综合症患者不同促排卵方案临床疗效分析

目的：以行体外受精-胚胎移植（IVF-ET）治疗的多囊卵巢综合症（PCOS）患者为研究对象,分别采用GnRH激动剂（GnRH-a）长方案（Ⅰ组）、GnRH拮抗剂（GnRH-A）方案（Ⅱ组）进行促排卵治疗,通过两组临床结局的比较,寻求更适宜PCOS患者的促排卵治疗方案。方法：选择2008年1月至2010年6月就诊于我院不孕不育专科门诊的62名多囊卵巢综合症患者,这些患者在我院门诊接受促排卵治疗后于北京大学人民医院生殖中心接受IVF-ET治疗。根据不同的促排卵方案将患者分成两组,比较各组患者的基本特征、Gn用药天数、Gn量、HCG日LH水平、E2水平、获卵数、受精率、妊娠率、周期取消率、OHSS发生率等。结果：两组患者Gn剂量差异有统计学意义（P〈0.05）,GnRH-A组低于GnRH-a长方案组;两组获卵数、MII卵泡数、胚胎种植率、临床妊娠率等比较差异均无统计学意义（P〉0.05）;两组患者的HCG日血清E2水平、LH水平差异有统计学意义（P〈0.05）,GnRH-A组低于GnRH-a长方案组;两组患者的流产率、OHSS发生率差异无统计学意义（P〉0.05）。结论：使用GnRH-A方案有效减少了IVF-ET的PCOS患者Gn的使用量,减轻了患者的经济和心理负担,是PCOS患者行VF-ET较为适宜的促排卵方案。

Curative effect of different ovulation simulation scheme for patients with polycystic ovary syndrome

Objectives： Patients with polycystic ovary syndrome（ PCOS） and having received in vitro fertilization- embryo transfer（ IVF- ET） treatment were regarded as the research object. 2 schemes,GnRH agonist（ GnRH- a） long scheme（ groupⅠ） and GnRH antagonists（ GnRH- A） scheme（ groupⅡ） were adopted to stimulate ovulation,to identify the ovulation simulation scheme more suitable for patients with PCOS through comparing the clinical outcomes of the two groups. Methods： Sixty- two patients with polycystic ovary syndrome came to the Department of Infertility of our hospital between January 2008 and June 2008 were selected. After receiving ovulation simulation treatment in our hospital,the 62 patients went to the reproductive center of Peking University People＇s Hospital to receive IVF- ET treatment. According to the different ovulation stimulation scheme adopted,patients were divided into 2 groups. The basic characteristics,number of days taking Gn,amount of Gn,level of LH and E2 on HCG days,number of eggs,fertilization rate,pregnancy rate,cycle cancellation rate and the incidence of OHSS and etc of the two groups were compared. Results： The amount of Gn in the GnRH- A group was lower than GnRH- a long scheme,demonstrating significant statistical difference（ P〈0. 05）; the number of eggs and MII follicle,embryo implantation rate,clinical pregnancy rate were of no significant statistical difference（ P〉0. 05）; the levels of serum E2 and LH on HCG day were of significant statistical difference（ P〈0. 05）,GnRH-A group lower than GnRH- a long scheme; the abortion rate and incidence of OHSS in both groups were of no significant statistical difference（ P〉0. 05）. Conclusion： GnRH- A scheme effectively reduces the usage of Gn for patients with PCOS and IVF- ET treatment,thusly reducing the economic and psychological burden of patients. It is a more suitable treatment plan.