论文部分内容阅读
目的探讨不同超排方案对EMT患者取卵日中卵泡液的VEGF水平及其对助孕结局的影响。方法对腹腔镜下诊断为子宫内膜异位症(II期或以上)并需要进行IVF-ET助孕的90例患者,随机分为A,B,C 3组,分别采用超长方案(A组),孕三烯酮+常规长方案(B组)及常规长方案(C组),及对照组(D组):同期因输卵管因因素采用常规长方案进行IVF-ET助孕的30例患者。比较四组间年龄,不孕年限,基础FSH水平,基础LH水平,基础E2水平,Gn天数,Gn用量,HCG日LH水平,HCG日P水平,HCG日E2水平,取卵日成熟卵泡的卵泡液中VEGF水平,并比较四组间的获卵数,受精率,卵裂率,优胚率,胚胎着床率,临床妊娠率,流产率。结果 EMT常规长方案(C组)与对照组(D组)比较:C组卵泡液中VEGF水平高于D组,优胚率,胚胎着床率及临床妊娠率低于D组,流产率高于D组,差异有统计学意义P<0.05);超长方案(A组),孕三烯酮+常规长方案(B组)及常规长方案(C组)3组两两比较卵泡液中VEGF水平比较差异无统计学意义,但A,B两组测量值均低于C组;A,B组优胚率高于C组,A组的胚胎着床率高于B,C组,流产率低于B,C组,比较差异有统计学意义P<0.05)。A组的Gn天数,Gn用量明显大于B,C两组,比较差异有统计学意义P<0.05);3组妊娠率两比较,A组>B组>C组,但差异无统计学意义。结论常规长方案进行IVF-ET助孕的EMT患者(C组)卵泡液中VEGF水平高于其因输卵管因素采用常规长方案进行IVF-ET助孕的患者(D组),优胚率及胚胎着床率及临床妊娠率低,流产率高;而超长方案(A组)及孕三烯酮+常规长方案(B组)可降低EMT患者卵泡液中VEGF水平,可获得较高的优胚率,胚胎着床率,有助于改善EMT患者的助孕结局。
Objective To investigate the effect of different superovulation on the level of ovulation follicular fluid in EMT patients and its effect on pregnancy outcome. Methods Ninety patients undergoing laparoscopic diagnosis of endometriosis (stage II or above) and requiring IVF-ET assisted pregnancy were randomly divided into three groups: A, B and C, (G), gestrinone + conventional long-term regimen (group B) and conventional long regimen (group C), and control group (D): 30 cases of IVF-ET assisted pregnancy with conventional long- patient. The age, the duration of infertility, basal FSH level, basal LH level, basal E2 level, Gn days, Gn level, HCG day LH level, HCG day P level, HCG day E2 level were compared between the four groups. Fluid VEGF levels were compared between the four groups and the number of oocytes, fertilization rate, cleavage rate, excellent embryo rate, embryo implantation rate, clinical pregnancy rate, abortion rate. Results Compared with the control group (group C), the long-term EMT regimen (group C) showed that the level of VEGF in group C was higher than that in group D, the excellent embryo rate, embryo implantation rate and clinical pregnancy rate were lower than those in group D, and the abortion rate was high In group D, the difference was statistically significant (P <0.05); in the long-term regimen (group A), gestrinone + conventional regimen (group B) and conventional long regimen (group C) The levels of VEGF in group A and group B were lower than those in group C, while those in group A and B were higher than those in group C. The implantation rate of embryos in group A was higher than that in group B and C Rate lower than B, C group, the difference was statistically significant P <0.05). The number of Gn days and Gn in group A were significantly higher than those in group B and C (P <0.05). There was no significant difference in pregnancy rate between the three groups and group A> group B> C. CONCLUSIONS: The levels of VEGF in follicular fluid of IVF-ET-assisted pregnancies (group C) are higher than those of patients whose ovulation causes long-term IVF-ET with oviduct (group D), excellent embryo rate and embryo Implantation rate and clinical pregnancy rate is low, abortion rate is high; and long program (A group) and gestrinone + conventional long-term program (B group) can reduce the level of VEGF in follicular fluid EMT patients can obtain higher Embryo rate, embryo implantation rate, help to improve the pregnancy outcome of patients with EMT.