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目的评估灵活剂量促性腺激素释放激素拮抗剂(GnRH-A)方案和标准半量的GnRH-A方案在多囊卵巢综合征(PCOS)患者微刺激周期进行体外受精-胚胎移植(IVF-ET)/卵细胞浆内单精子注射(ICSI)的超促排卵过程中的应用价值。方法回顾性分析88例PCOS患者采用克罗米芬微刺激方案联合使用GnRH-A进行IVF-ET助孕,其中46例使用灵活剂量GnRH-A方案(A组),42例使用标准半量GnRH-A方案(B组)。比较各组实验室指标和临床结局。结果与B组比较,A组人绒毛膜促性腺激素(h CG)日促黄体生成素(LH)、孕酮(P)水平明显降低,受精率、卵裂率、优质胚胎率、新鲜胚胎移植周期临床妊娠率显著升高,差异有统计学意义(P<0.05);Gn天数、Gn用量、内膜厚度、获卵数、成熟卵数及新鲜胚胎移植周期移植胚胎数组间无统计学差异(P>0.05)。结论与标准半量GnRH-A方案相比,灵活的GnRH-A联合微刺激方案可获得更多的优质胚胎,提高临床妊娠率和胚胎着床率。
Objective To evaluate the efficacy and safety of in vitro fertilization-embryo transfer (IVF-ET) / GnRH-A regimen in patients with polycystic ovary syndrome (PCOS) The value of intracytoplasmic sperm injection (ICSI) in the process of superovulation. Methods Retrospective analysis of 88 patients with PCOS using clomiphene citrate stimulation combined with GnRH-A for IVF-ET assisted pregnancy, 46 patients with flexible dose GnRH-A regimen (group A), 42 patients with standard half-dose GnRH-A regimen (Group B). Compare each group laboratory index and clinical outcome. Results Compared with group B, the levels of LH and progesterone (P) in group A were significantly lower than those in group B, and the fertilization rate, cleavage rate, high quality embryo rate, fresh embryo transfer Cycle clinical pregnancy rate was significantly increased, the difference was statistically significant (P <0.05); Gn days, Gn dosage, thickness of the intima, number of oocytes, mature eggs and fresh embryo transfer embryos transplantation embryos array was no significant difference P> 0.05). Conclusion Compared with the standard half-dose GnRH-A regimen, the flexible GnRH-A combined with micro-stimulation regimen can obtain more high quality embryos and improve clinical pregnancy rate and embryo implantation rate.