改良长方案在初次拮抗剂方案助孕治疗失败患者中的应用

目的:比较改良长方案和拮抗剂方案在初次拮抗剂方案失败患者中的临床结局。方法:回顾分析初次拮抗剂方案失败行再次IVF/ICSI助孕治疗的169例患者,其中130例采用改良长方案治疗(研究组),39例采用拮抗剂方案治疗(对照组)。结果:两组患者的一般情况无明显差异(P0.05)。研究组的注射HCG日E2值、Gn用药时间和Gn剂量均显著高于对照组(P0.05),注射HCG日LH值显著低于对照组(P0.05)。研究组的临床妊娠率、种植率及活产率分别为55.2%、36.4%和46.4%,均显著高于对照组(27.3%、22.0%和21.2%)(P0.05)。结论:初次拮抗剂方案失败行再次助孕治疗的患者中,改良长方案可能通过改善子宫内膜的容受性,获得了较拮抗剂方案更好的妊娠结局。

Clinical outcomes of modified long protocol used in patients who failed in first cycle with antagonist protocol

Objective: To compare IVF outcomes with modified long protocol and antagonist protocol in women who failed in their first IVF attempt with antagonist protocol. Methods: A total of 169 patients failed in first cycle with antagonist protocol who underwent the secondary cycles were retrospectively analyzed. Patients were divided into two groups: the study group included 130 patients receiving modified long protocol and the control group included 39patients receiving flexible antagonist protocol. Results: There was no significant difference in general characteristics between the two groups( P >0. 05). E2level on HCG injection day,Gn duration and dosage in study group were higher than those in control group. The LH level on HCG injection day was significantly lower than the control group( P <0. 05). Comparing with control group,clinical pregnancy rate( 55. 2% vs 27. 3%),implantation rate( 36. 4% vs 22%)and live birth rate( 46. 4% vs 21. 2%) in study group was significantly higher( P<0. 05). Conclusions: Modified long protocol provides a better outcome in patients who failed in their first IVF attempt with antagonist protocol in comparison with flexible antagonist protocol probably.