体外受精周期卵巢储备功能正常采用激动剂长方案与拮抗剂方案促排卵的临床结局比较

目的:探讨卵巢储备功能正常者采用激动剂长方案和拮抗剂方案促排卵对体外受精周期妊娠结局的影响。方法:回顾性分析卵巢储备功能正常者进行体外受精-胚胎移植(IVF-ET)的265个周期。根据促排卵方案不同将其分为:激动剂长方案促排卵组(长方案组,157个周期),拮抗剂方案组(拮抗剂组,108个周期)。结果:患者的年龄、不孕年限、体质量指数(BMI)、基础性激素水平等一般情况组间均无统计学差异(P>0.05)。hCG注射日直径14 mm以上的卵泡数、hCG注射日E2水平、平均移植胚胎数及胚胎质量、受精率、生化妊娠率、早期流产率等组间均亦无统计学差异(P>0.05);但获卵数(12.6±4.6 vs 10.8±4.6)、可用胚胎数(5.0±3.0 vs 4.2±2.7)、胚胎种植率(29.87%vs 20.98%)、临床妊娠率(42.76%vs 28.70%)长方案组明显高于拮抗剂组,差异有统计学意义(P<0.05)。结论:卵巢储备功能正常者拮抗剂促排卵,其胚胎种植率、临床妊娠率明显低于长方案组。

Effect of GnRH Agonist Long Protocol and GnRH Antagonist Protocol in Normal Ovarian Reserve during in vitro Fertilization on Pregnancy Outcomes

Objective: To evaluate the effect of GnRH agonist long protocol and GnRH antagonist for ovarian stimulation in normal ovarian reserve patients during in vitro fertilization on pregnancy outcomes.Methods: A total of 265 fresh cycles in normal ovarian reserve patients during in vitro fertilization-embryo transfer(IVF-ET) were evaluated retrospectively in the study.Cycles were divided into two groups according to the different stimulation protocols: there were 157 cycles in GnRH agonist(GnRH-a) group,which adopt GnRH-a long protocol for ovarian stimulation,and the remaining 108 cycles use GnRH antagonist(GnRH-A) protocol for ovarian stimulation in GnRH-A group.Results: The genenal features such as patient’s age,infertility duration,body mass index,basal sex hormone levels between the two groups were not statistically different(P>0.05).To compare ovarian stimulation characteristics and clinical outcomes in the two groups,the number of follicle that diameter was beyond 14 mm on the day of hCG administration,serum E 2 concentrations on the day of hCG administration,the meaning transfered embryos and embryo quality,fertilization rate,biochemical pregnancy rate,early miscarriage rates were not statistically different(P>0.05);however,the number of retrieved oocytes(12.6 ± 4.6 vs 10.8 ± 4.6),the number of available embryos(5.0 ± 3.0 vs 4.2 ± 2.7),embryo implantation rate(29.87% vs 20.98%),and clinical pregnancy rate(42.76% vs 28.70%) in GnRH-a group were significantly higher than those in GnRH-A group(all P<0.05).Conclusion: Using GnRH-A for ovarian induction in normal ovarian reserve patients,embryo implantation rate and clinical pregnancy rate were significantly lower than those in GnRH-a group.