促排卵周期中曲谱瑞林触发排卵的临床研究

【目的】探讨短效促性腺激素释放激素激动剂(GnRH-a)曲普瑞林在促排卵治疗中的疗效。【方法】收集接受供精人工授精助孕的不孕患者223例共255周期，当卵泡成熟时，根据不同的触发排卵方案分成两组：采用曲普瑞林触发排卵92周期为观察组；采用人绒毛膜促性腺激素(HCG)触发排卵163周期为对照组，比较两组的临床结局。【结果】两组的周期排卵率比较差异有统计学意义(P <0.05)；两组触发排卵后24 h、48 h、72 h 周期排卵率比较有显著性差异(P <0.05)。比较两组的周期临床妊娠率、流产率、多胎率、卵巢过度刺激综合征(OHSS)发生率差异均无统计学意义(P >0.05)。【结论】在供精人工授精促排卵治疗周期中短效 GnRH-a 能有效的触发排卵，尤其当优势卵泡数大于2个时，在获得与 HCG 相似的排卵效果及妊娠结局的同时，能降低卵巢过度刺激综合征(OHSS)发生风险，但应重视黄体支持。

Clinical Evaluation of Triptorelin on Triggering Vulation in the Hyperstimulaton Cycle

Objective]To investigate the effect of triggering oocyte maturation and inducing ovulation by gonadotro-pin-releasing hormone agonist (GnRH-a)in artificial insemination by donor.Methods]We retrospectively studied 255 AID cycles.When follicular maturation was completed,the patients were divided into research group and control group. The research group involved 92 cycles in which ovulation was triggered with GnRH-a,the control group involved 163 cy-cles in which ovulation was triggered with HCG.Results]The ovulation rate was significantly different between the two groups(P <0.05),and after triggering oocyte maturation,there were significant differences of the ovulation rate of 20, 48,and 72 hours between the two groups(P <0.05).However,there was no significant difference of pregnancy rate, rate of early abortion,OHSS,and multiple pregnancy rate between the two groups(P >0.05).Conclusion]Artificial in-semination by donor cycles with GnRH-a is able to effectively trigger oocyte maturation,especially when the leading folliculars were more than two,the outcome of ovulation and pregnancy of GnRH-a is similar to the outcome of HCG treatment.Luteal support should be important.