论文部分内容阅读
目的探讨体外受精-胚胎移植(IVF-ET)超促排卵长方案中不同的降调节方案对临床结局的影响。方法回顾性分析行控制性超促排卵长方案277个周期,根据GnRHa用药方案不同分为4组,A组(nA=31):黄体中期给予长效达菲林1.5mg,注射一次;B组(nB=102):黄体黄体中期给予短效0.1mg/d,14d后减至0.05mg/d至HCG日;C组(nC=85):黄体黄体中期给予短效0.1mg/d,18d后减至0.05 mg/d至HCG日;;D组(nD=59):黄体黄体中期给予短效0.05mg/d,每日皮下注射至HCG日。结果 4组周期获卵数、受精率、可利用胚胎数及临床妊娠率比较差异均无统计学意义(P>0.05);A组Gn用药时间长,用药量最大,与其他三组比较有统计学意义(P<0.05),C组的用药时间及用药量较B、D组大(P<0.05);HCG日LH值的比较,D组高于其他三组(P<0.05),有统计学意义;HCG日E2的比较,A组高于B、C、D组,C组高于B、D组,有统计学意义(P<0.05)。结论各组均能达到控制性超排卵的降调节作用,短效达菲林0.1 mg/d 18d组Gn用药时间长,用药量大,0.05mg/d 18d组在控制性促排卵中LH值相对较高,可能影响卵子质量;在保证降调节标准,提高妊娠率的前提下,如何调节GnRHa用药方案有待进一步研究。
Objective To investigate the effect of different down-regulation regimens in IVF-ET long-term regimen on clinical outcomes. Methods A retrospective analysis of 277 cycles of long-term controlled ovarian hyperstimulation was divided into 4 groups according to the GnRHa dosage regimen: group A (nA = 31) nB = 102): Luteal corpus luteum medium short-term effect of 0.1mg / d, reduced to 0.05mg / d HCG after 14d; C group (nC = 85): luteal corpus luteum middle short-term effect of 0.1mg / d, To 0.05 mg / d to HCG day; Group D (nD = 59): Luteal corpus luteum mid-term given short-acting 0.05mg / d, daily subcutaneous injection to HCG day. Results There was no significant difference in the number of oocytes retrieved, the fertilization rate, the number of available embryos and the clinical pregnancy rate among the 4 groups (P> 0.05). The Gn administration time was the highest in group A, the dosage was the largest, compared with the other three groups (P <0.05). The duration and dosage of drug in group C were significantly higher than those in group B and D (P <0.05). The LH of HCG in group D was higher than that in group D (P <0.05) Significance of learning; E2 on HCG day was higher in group A than in groups B, C and D, and in group C was higher than that in group B and D (P <0.05). Conclusions The controllable superovulation can be down-regulated in all the groups. Short-acting Tamiflu in 0.1 mg / d for 18 days showed a long duration of Gn treatment, and the dosage was large. The LH value in the controllable ovulation induced by 0.05 mg / d for 18 days High, may affect the quality of eggs; in ensuring the regulation of down regulation, to improve the pregnancy rate under the premise of how to regulate GnRHa medication needs further study.