口服避孕药预处理在体外受精-胚胎移植中的利弊研究

目的 评估口服避孕药预处理在体外受精-胚胎移植周期中的利弊,为生殖中心临床合理应用口服避孕药(Oral contraceptive,OCP)提供依据.方法 回顾性分析341例行IVF/ICSI的患者,按促排卵周期前是否使用过OCP药物分为OCP治疗组182例和对照组159例,对入选患者的病历资料进行统计分析,评估口服避孕药对患者促排卵的效果以及对助孕结局的利弊影响.结果 OCP预处理明显减少卵巢功能性囊肿形成(P＜0.0001).OCP处理组比对照组Gn天数平均增加0.34d(P=0.042),但剂量总量差异无统计学意义(P=0.55),且两组获卵数、成熟卵数、总受精数、正常受精数、卵裂数、卵巢过度刺激发生率、流产率、临床妊娠率等差异均无统计学意义.结论 OCP预处理能较好地控制促排卵的时间,有利于医务人员安排不孕患者进周期的时间,同时也减轻了患者往返医院监测排卵的不便,又能有效减少卵巢功能性囊肿形成,但对助孕结局无明显改善.

The advantages and disadvantages of oral contraceptive pill pretreatment in vitro fertilization and embryo transfer

Objective To assess The advantages and disadvantages of oral contraceptive pill(OCP) pretreatment in ovarian Stimulation for in vitro-fertilization(IVF) using gonadotropin releasing hormone(GnRH) agonists and offer the true proofs to clinical doctors.Methods 341 patients were randomly divided into group OCPs,who received OCPs pretreatment before IVF cycle(n=182),and group B,who did not(n=159).A retrospective analysis of the anamnestic data of the patients was carried out for the assessment of the ovulation promoting effect of OCP and their influence on the IVF-ET operation.Results The formation of ovarian cystwas significant decreased in OCPs group(P=0.00).Compared with the control group,the number of antral follicle significant decreased.A mean of 0.35 days were increased in OCPs pretreatment group(11.67 versus 11.32 days,P=0.042),but no significant differences were observed regarding the number of average gonadotropin cumulusoocyte complexes(COCs),abortion rates,clinical pregnancy rates and the fertilization rates.Conclusion Oral contraceptive pill(OCP)pretreatment could help the doctor to control the time of ovarian stimulation,effectively reduce the work time of medical staff.It may improve the responsively of ovary moderately and increase the synchronism of follicular development,though the duration of gonadotropin stimulation is significantly increased in OCP pretreatment groups.