广州医药 ›› 2021, Vol. 52 ›› Issue (6): 49-53.DOI: 10.3969/j.issn.1000-8535.2021.06.010

• 论著 • 上一篇    下一篇

不同超促排卵方案在非卵巢多囊样改变高反应人群的应用

谢重驹, 劳群秀, 杨美琼, 马文敏   

  1. 佛山市妇幼保健院(佛山 528000)
  • 收稿日期:2021-05-11 出版日期:2021-11-20 发布日期:2021-11-26
  • 通讯作者: 马文敏,E-mail:mwm341@sohu.com

Application of different progestin-primed ovarian stimulation in non-PCOM patients with high ovarian response

XIE Zhongju, LAO Qunxiu, YANG Meiqiong, MA Wenmin   

  1. Foshan Women and Children Hospital, Foshan 528000,China
  • Received:2021-05-11 Online:2021-11-20 Published:2021-11-26

摘要: 目的 研讨不同促排方案在非卵巢多囊样改变高反应人群的疗效。方法 回顾分析2018年1月—2019年12月在我院进行体外受精助孕患者共711周期(含389个胚胎移植周期)。分为三组:A组:采用卵泡期长方案414周期(232个移植周期)。B组:采用黄体期长方案221周期(121个移植周期);C组:采用拮抗剂方案76周期(36个移植周期)。结果 A组的卵泡输出率(follicular output rate,FORT)最高;B组获卵数、2PN数、卵泡卵母细胞转化指数为三组中最高,但临床妊娠率、种植率最低;C组的人绒毛膜促性腺激素日促黄体生成素、每卵雌二醇水平为三组最高,但FORT、≥16 mm优势卵泡数最低。结论 在非卵巢多囊样改变高反应患者中,卵泡期长方案较黄体期长方案更利于改善妊娠结局,拮抗剂方案更经济、安全。

关键词: 控制性卵巢刺激, 卵巢高反应, 卵泡输出率

Abstract: Objective To investigate the efficacy of different progestin-primed ovarian stimulation in non-polycystic ovarian morphology(non-PCOM) patients with high ovarian response. Methods A total of 711 cycles for in-vitro fertilization treatment(including 389 embryos transfer cycles) in our hospital from October 2018 to November 2019 were summarized in this retrospective study. All the patients were divided into three groups. In group A, 414 cycles for follicular phase gonadotropin-releasing hormone(GnRH) agonist long protocol(including 232 embryos transfer cycles)was used. In group B, 221 cycles for luteal phase GnRH agonist long protocol(including 121 embryos transfer cycles)was used. In group C, 76 cycles for GnRH antagonist protocol(including 36 embryos transfer cycles)was used. Results Follicular output rate(FORT) in group A was the highest. The number of oocytes, 2PN embryos and follicle-to-oocyte index in group B were the highest among the three groups,while the clinical pregnancy rate and implantation rate were the lowest. Luteinizing hormone on human chorionic gonadotropin injection day、estradiol level per follicle in group C were the highest,while FORT and the number of ≥16 mm dominant follicles were the lowest. Conclusion In non-PCOM patients with high ovarian response,follicular phase GnRH agonist protocol had better pregnancy outcome compared with luteal phase GnRH agonist protocol, and the GnRH antagonist protocol appeared to be more economical and safe.

Key words: controlled ovarian stimulation, high ovarian response, follicular output rate