两种控制性超促排卵方案在卵巢低反应患者中的临床研究

目的:探讨标准长方案与拮抗剂方案控制性超促排卵(COH)周期在卵巢低反应(POR)患者中的临床效果。方法:通过对POR患者行体外受精-胚胎移植(IVF-ET)的191个周期进行回顾性分析,其中GnRH-a长方案85个周期(A组),拮抗剂方案106个周期(B组),比较组间的临床资料及助孕结局。结果:A组的hCG注射日内膜厚度、获卵数、MII卵子数、可移植胚胎数、活产分娩率均高于B组,差异有统计学意义(P0.05);A组的优质胚胎数、胚胎种植率、移植周期妊娠率均高于B组,A组的周期取消率、流产率均低于B组,但差异均无统计学意义(P0.05)。结论:标准长方案对卵巢低反应患者有较好的治疗效果;标准长方案可提高患者获卵数、可移植胚胎数、活产分娩率。

Clinical Evaluation of Two Protocols with Controlled Ovarian Hyperstimulation in Poor Response

Objective： To evaluate the clinical efficacy of GnRH antagonist or long GnRH agonist protocol for patients with poor ovarian response （POR）. Methods： A total of 191 cycles of the patients with POR who were treated with IVF were retrospectively analyzed. These patients were divided into 2 groups： long GnRH agonist （GnRH-a） protocol with 85 cycles （group A）, GnRH antagonist （GnRH-A） protocol with 106 cycles （group B）. Clinical data and outcome were compared between the two groups. Results： The thickness of endometrium on hCG injection day and the number of oocytes retrieved, MⅡ oocyte retrieved, available embryos and live birth rates were significantly higher in group A than in group B （P〈0.05）. The number of high-quality embryos, the implantation rate and the clinical pregnancy rate of the embryo transfer cycle in group A were higher than those in group B. The cycle cancellation rate and the abortion rate in group A showed slightly high values, but no statistical significance was found between the two groups （P〉0.05）. Conclusion： Long GnRH-a protocol would be more applicable to the patients with POR. Long GnRH-a protocol can improve the number of oocytes retrieved, available embryos and live birth rates in poor ovarian response.