低剂量降调节改良超长方案在重复周期ivf低剂量降调节改良超长方案在重复周期ivf.doc

低剂量降调节改良超长方案在重复周期IVF / ICSI-ET患者中的应用 摘要:探讨低剂量促性腺激素释放激素激动剂(GnRH－a)改良超长降调节对体外受精／卵胞浆内单精子注射一胚胎移植术(IVF／ICSI—ET)结局的影响。方法 ：选择2011年7月至2013年7月在我院既往已行IVF／ICSI—ET 1-3周期未孕患者 226例，其中A组多囊卵巢综合征( PCOS) 患者 86例，B组卵巢低反应患者43例，C组单纯输卵管因素或男方因素患者97例，所有患者在前一周期中均为常规长方案促排卵。在本周期中均采用改良超长方案，两次降调节达菲林用量均小于或等于1.25mg(1/3支)。比较三组患者前后两个不同促排卵周期超促排卵天数、Gn 用量、启动日及HCG 日血清激素水平、获卵数、优质胚胎率、临床妊娠率等。结果 ：三组患者前后两个周期HCG 日E2值及P值、HCG 日子宫内膜厚度、获卵数、受精率、优质胚胎率比较无统计学差异( P ＞ 0. 05) ;三组的改良超长周期Gn总剂量C组增加，A、B两组减少，但均无统计学差异( P ＞ 0. 05) ; 启动日FSH值、胚胎着床率、临床妊娠率，改良超长周期较长方案周期高，Gn 天数缩短，均有统计学差异( P ＜ 0. 05)。结论 ：低剂量降调节改良超长方案对于大多数患者是一种有效、经济的促排卵方案。 【关键词】 IVF / ICSI-ET 改良超长方案 促性腺激素释放激素激动剂 多囊卵巢综合征 卵巢低反应 Application of low dose reduction on modified super-long down - regulation protocol in repeating cycles of IVF / ICSI-ET patients.CHEN Yan ,JIA Xiao-Li The Center of reproductive, Maternal and child health care hospital of Shaoguan ,Guangdong, 512026)[Abstract] Objective:To investigate the effect of low dose gonadotropin releasing hormone agonist (GnRH - a) modified long down regulation of in vitro fertilization and intracytoplasmic sperm injection and embryo transplantation (IVF / ICSI - ET) outcome. Methods: From 2011July to 2013July in our hospital in the IVF / ICSI has been ET 1-3 cycle non-pregnant patients in 226 cases, A group of polycystic ovary syndrome (PCOS) patients with 86 cases, group B 43 cases of patients with ovarian poor response, C group of tubal or male factors in patients with 97 cases, all patients in the previous cycle are conventional long protocol ovulation. Improved long program was applied in this cycle, two times the amount of the down regulation of Tamiflu is less than or equal to 1.25mg (1/3). Comparison of three groups of patients before and after two different ovulation hyperstimulation days, the dosage of Gn, start the serum hormone levels, and HCG the number of retrieved oocytes, high-quality embryo rate, clinical pregnancy rate. Results : HCG for two cycles, three groups of patients before and aft