口服避孕药预处理在卵巢功能储备良好而前次IVF失败患者中的应用效果

目的:评估口服避孕药(OC)预处理在卵巢储备良好、前次IVF失败患者中的应用效果。方法:回顾分析131例卵巢储备功能良好、前次IVF常规黄体中期降调节长方案失败再次行助孕治疗的患者资料,其中口服避孕药预处理后长方案治疗52例为研究组,黄体中期长方案治疗79例为对照组。结果:研究组降调节后LH值明显低于对照组,双原核(2PN)率和卵裂率明显高于对照组,可利用胚胎数明显高于对照组(P<0.05);但Gn使用时间、Gn使用量、获卵数、MII卵数、移植日子宫内膜厚度、生化及临床妊娠率、因OHSS倾向取消移植率与对照组比较均无明显统计学差异(P>0.05)。结论:在有自发排卵的卵巢储备功能良好、前次IVF常规长方案失败、再次选用长方案超促排卵(COH)治疗的患者中,使用OC预处理能够降低降调节后LH值,改善正常受精率,增加可利用胚胎数,是值得推荐的治疗方案。

Effect Analysis of Oral Contraceptive Pills for Pretreatment on Next IVF Outcome of Patients Failed Previously with Fine Ovary Reserve

Objective: To evaluate the effect of oral contraceptive pills(OC) for pretreatment on the onceagain IVF cycle outcome of patients with fine ovary reserve and previous failing IVF/ICSI-ET cycle.Methods: A total of 131 patients with previous failing cycle of mid-luteal phase GnRHa long protocol but with fine ovary reserve who underwent a second-time IVF were retrospectively analyzed.All cases were divided into 2 groups: OC group of 52 patients were treated with long protocol cycle after OC pretreatment,while the control included 79 patients who underwent long protocol treated with GnRHa from mid-luteal phase.Results: The LH level after down regulation in OC group was significantly lower than that in the control,while the fertilization rate,the cleavage rate and the number of utilized embryo were significantly higher than those in the control.But for the items of the number of stimulation days,total ampoules of gonadotropin(Gn),the number of oocytes retrieved,the number of MIIoocytes,thickness of endometrium on ET day,pregnancy rates and OHSS inclination caused cycle cancel rates,there were no significant differences between the two groups.Conclusion: For patients with fine ovary reserve and spontaneous ovulation who failed in previous IVF regular long protocol cycle and underwent long protocol controlled ovarian stimulation again,OC pretreatment can decrease LH level after down regulation,improve the fertilization rate and increase utilized embryo number,which proved recommendable way of treatment protocol.