期刊文献+

拮抗剂方案与改良超长方案在卵巢高反应人群中应用的比较 预览

Comparison of antagonist protocol and modified super-long protocol in patients with high ovarian response
在线阅读 免费下载
分享 导出
摘要 目的比较拮抗剂方案与改良超长方案在卵巢高反应患者中应用的临床疗效。方法回顾性分析2015年1月至2017年9月在本院行IVF/ICSI的卵巢高反应患者(获卵数 >15个)共853个周期的临床资料。按促排卵方案分为两组,其中拮抗剂方案组186个周期、改良超长方案组667个周期。比较患者的一般情况和临床结局。结果与改良超长方案组比较,拮抗剂方案组Gn总量[(1544.15±412.52)Uvs.(2949.87±1156.05)U]、Gn天数[(10.08±1.33)dvs.(13.81±1.87)d]均显著减少(P<0.05),获卵数[(23.41±6.20)vs.(21.96±5.24)]、HCG日E2[(24087.76±8309.59)pmol/Lvs.(22281.31±6830.78)pmol/L]均显著增高(P<0.05),HCG日P/E2值[(0.36±0.20)vs.(0.42±0.20)显著降低(P<0.05);与改良超长方案组比较,拮抗剂方案组胚胎种植率(33.20%vs.46.29%)、临床妊娠率(47.37%vs.63.80%)、抱婴率(32.33%vs.48.86%)均显著降低(P<0.05),但中重度卵巢过度刺激综合征(OHSS)发生率(8.60%vs.15.44%)、移植取消率(28.49%vs.40.78%)亦显著降低(P<0.05)。结论卵巢高反应人群中拮抗剂方案临床结局显著低于改良超长方案,可能与其降低子宫内膜容受性有关,因此应考虑全胚冻存行解冻移植使其降低OHSS风险的同时有良好的妊娠结局。 Objective:To compare the clinical efficacy of GnRH antagonist(GnRH-ant)protocol and modified super-long protocol in the patients with high ovarian response.Methods:The data of 853 IVF/ICSI cycles of the patients with high ovarian response(number of oocytes retrieved >15)in our hospital from Jan.2015 to Sep.2017 were retrospectively analyzed.According to the ovulation induction protocol,they were divided into two groups:the GnRH-ant group(n=186 cycles)and the modified super-long group(n=667 cycles).The general condition and clinical outcome of the patients were compared.Results:Compared to the modified super-long group,the total dosage[(1 544.15±412.52)vs.(2 949.87±1 156.05)U]and days of Gn used[(10.08±1.33)vs.(13.81±1.87)days]were significantly lower(P<0.05).The number of oocytes retrieved[(23.41±6.20)vs.(21.96±5.24)]and the serum E 2 levels on HCG day[(24 087.76±8 309.59)vs.(22 281.31±6 830.78)pmol/L]were significantly higher(P<0.05)and the P/E 2 value on HCG day[(0.36±0.20)vs.(0.42±0.20)was significantly lower in the antagonist group(P<0.05).The implantation rate(33.20%vs.46.29%),clinical pregnancy rate(47.37%vs.63.80%)and live birth rate(32.33%vs.48.86%)were significantly lower in the antagonist group as compared to the modified super-long group(P<0.05).The incidence of moderate and severe OHSS(8.60%vs.15.44%)and cancellation rate of transplantation(28.49%vs.40.78%)were significantly lower in the antagonist group(P<0.05).Conclusions:The clinical outcome of the antagonist protocol in patients with high ovarian response is significantly lower than that of the modified super-long protocol,which may be related to the reduction of endometrial receptivity,so it should be considered whole embryo cryopreservation for frozen-thawed transplantation to reduce the risk of OHSS to obtain good pregnancy outcome.
作者 蔡文元 马晓玲 张学红 赵丽辉 贾学玲 刘琨 杜文静 张瑞 刘琳 CAI Wen-yuan;MA Xiao-ling;ZHANG Xue-hong;ZHAO Li-hui;JIA Xue-ling;LIU Kun;DU Wen-jing;ZHANG Rui;LIU Lin(The Reproductive Medicine Special Hospital of the first Hospital of Lanzhou University,Key Laboratory for Reproductive Medicine&Embryo,Gansu Province,Lanzhou730000)
出处 《生殖医学杂志》 CAS 2019年第2期134-139,共6页 Journal of Reproductive Medicine
基金 兰州市人才创新创业项目(2016-RC-51).
关键词 拮抗剂方案 改良超长方案 卵巢高反应 临床结局 卵巢过度刺激综合征 GnRH-antagonist protocol Modified Super-long protocol High ovarian response Clinical outcome OHSS
作者简介 蔡文元,男,甘肃会宁人,在读硕士生,生殖医学专业;通讯作者,张学红,Email:zhangxueh@lzu.edu.cn
  • 相关文献

参考文献2

二级参考文献23

  • 1Nardo LG, Bosch E, Lambalk CB, et al. Controlled ovarian hyperstimulation regimens:a review of the available evidence for clinical practice. Produced on behalf of the BFS Policy and Practice Committee[J]. Hum Fertil (Camb) , 2013,16 (3) : 144-150. 被引量:1
  • 2Al-Inany HG, Youssef MA, Aboulghar M, et al. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology[DB]. Cochrane Database Syst Rev, 2011, (5) :CD001750. 被引量:1
  • 3Papanikolaou EG, Pozzobon C, Kolibianakis EM, et al. Incidence and prediction of ovarian hyperstimulationsyndrome in women undergoing gonadotropin-releasing hormone antagonist in vitro fertilization cycles [Jl. Fertil Steril, 2006,85 : 112-120. 被引量:1
  • 4Broer SL,Dolleman M, van Disseldorp J, et al. Prediction of an excessive response in in vitro fertilization from patient characteristics and ovarian reserve tests and comparison in subgroups:an individual patient data meta-analysis[J]. Fertil Steril, 2013,100 : 420-429 e427. 被引量:1
  • 5Humaidan P, Quartarolo J, Papanikolaou EG. Preventing ovarian hyperstimulation syndrome:guidance for the clinician [J]. Fertil Steril,2010,94:389-400. 被引量:1
  • 6La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice[J]. Hum Reprod Update, 2014,20: 124-140. 被引量:1
  • 7Yates AP,Roberts SA, Nardo LG. Anti-Mullerian hormone- tailored stimulation protocols improve outcomes whilst reducing adverse effects and costs of IVF[J]. Hum Reprod, 2012,27:629. 被引量:1
  • 8van Tilhorg TC, Eijkemans MJ, Laven JS, et al. The OPTIMIST study: optimisation of cost effectiveness through individualised FSH stimulation randomised controlled trial[J]. 12,29. 被引量:1
  • 9dosages for IVF treatment. A BMC Womens Health, 2012, Coomarasamy A, Afnan M, Cheema D, et al. Urinary hMG recombinant FSH for controlled ovarian hyperstimulation following an agonist long down-regulation protocol in IVF or ICSI treatment: a systematic review and meta-analysis[J]. Hum Reprod, 2008,23 : 310-315. 被引量:1
  • 10Ferraretti AP, Gianaroli L, Magli C, et al. Elective cryopreservation of all pronucleate embryos in women at risk of ovarian hyperstimulation syndrome: efficiency and safety [J]. Hum Reprod,1999,14:1457-1460. 被引量:1

共引文献1

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈