适当地降调节在体外受精-胚胎移植长方案治疗中地价值.docVIP

适当的降调节在体外受精-胚胎移植长方案治疗中的价值 何 畏，俞炽阳，王凤英，李红梅，龙 玲，曲宗银，邓 丽，姚春丽（第三军医大学西南医院妇产科生殖中心, 重庆 400032） 摘 要：目的 探讨使用促性腺激素释放激素激动剂降调节在体外受精-胚胎移植治疗中的意义。方法 回顾分析我中心2008年1～12月185位例因不孕不育接受体外受精-胚胎移植助孕的长方案治疗周期共187个。根据促性腺激素使用前患者是否达到降调标准，分为达标组(A组，n = 95)与未达标组(B组，n = 92)。分析比较两组患者年龄、使用GnRH-a和Gn剂量、获卵数、成熟卵数、受精率、优质胚胎率、临床妊娠率等之间的差异。结果 A、B两组的临床妊娠率分别为48.94%和32.61%，达标组A组显著高于未达标组B组（P ＜ 0.05）；继续妊娠的观察中，二者的流产率无明显差别；达标组A组使用GnRH-a和Gn的剂量略大于未达标组B组，但两组间的差异无统计学意义。实验室资料显示两组的获卵数、MⅡ卵数以及受精率均较接近，均无明显差异（P ＞ 0.05）；而在优质胚胎获得率的对比中，达标组A组（43.70%）明显高于未达标组B组（31.80%）（P ＜ 0.05）。结论 在体外受精-胚胎移植的长方案治疗中，垂体降调节达标者的临床妊娠率高于未达标者。可见降调节是否充分和适当对助孕治疗的结局有重要意义。本中心现行的降调节标准是适宜的。 关键词：降调节；体外受精-胚胎移植；长方案；结局；GnRH-a 中图分类号： 文献标试码：A Value of Proper Pituitary down Regulation in the Treatment of IVF-ET HE Wei, YY YU Chi-yang, WANG Feng-ying, LI Hong-mei, LONG Ling, QU Zong-yin, DENG Li, YAO Chun-yan li ( Reproductive Medicine Center, Department of Obstetrics Gynecology, Southwest Hospital, Third Military Medical University, Chongqing, 430038, China) Abstract：Objective To evaluate the effect of pituitary down regulation induced by GnRH-a on the outcome of IVF-ET in our Reproductive Medicine Center. Methods 185 cases, which involved 187 cycles undergoing IVF/ICSI treatment, vwere retrospectively analyzed from Jan. to Dec. in 2008. All patients were got triptorelin 0.05mg per day from midluteal phase of the prior menstrual cycle (day18-21). According to the level of pituitary down regulation before controlling ovarian hyperstimulation (COH), patients were divided into two groups: full-down-regulation group (A-group, in brief) and not full-down-regulation group (B-group, in brief). The age, dose of GnRH–a and Gn, number of retrieved oocytes and metaphaseⅡoocytes, fertilization rate, high quality embryos and clinic pregnancy rate were compared. Results The rate of clinic pregnancy in the A group were obviously higher than its in B group (48.94% and 32.61%, respectively, P 0.05). No difference was observed in the abortion rate. Altho