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目的:探索经典长方案卵泡中/后期添加含活性黄体生成素(LH)的不同促性腺激素(Gn)制剂后行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)的最佳用药方案。方法:回顾性分析采用长方案行IVF/ICSI的1 441个周期患者的临床资料,根据中/后期所添加的Gn制剂不同,分为3组,A组为重组LH(r-LH)组,B组为人绝经期促性腺激素(h MG)组,C组为高纯h MG(HP-h MG)组。比较3组患者的Gn使用总量、Gn使用天数、获卵数、优质胚胎数、顶级优质胚胎数、临床妊娠率、活产率、早期流产率等。结果:C组Gn使用天数显著低于A组及B组,B组Gn使用总量显著高于A组及C组,A组和C组双原核(2PN)数、卵裂数、优质胚胎数、可利用胚胎数显著高于B组(P<0.05),但A组与C组比较无统计学差异(P>0.05);C组的顶级优质胚胎数高于A组及B组,差异有统计学意义(P<0.05)。种植率A组为44.0%,B组为38.2%,C组为42.5%,各组间无统计学差异(P>0.05)。临床妊娠率和活产率A组为62.5%和50.6%,B组为59.8%和44.0%,C组为65.3%和52.3%,A组和C组高于B组,但各组间比较无统计学差异(P>0.05);早期流产率各组间相似。结论:长方案卵泡中后期添加LH制剂可获得较好的临床结局,但添加HP-h MG与r-LH可以减少Gn使用天数和总量,增加顶级优质胚胎数,临床妊娠率和活产率有增高的趋势,总体临床结局均优于国产h MG。
OBJECTIVE: To explore the effect of IVF / ICSI-ET on classical long-term follicle in vitro / in vivo after adding different gonadotropin (Gn) preparations with active luteinizing hormone (LH) The best drug program. Methods: The clinical data of 1 441 cycles of long-term IVF / ICSI were retrospectively analyzed. According to the different Gn preparations added in the middle and late stages, the patients were divided into three groups. Group A was a group of recombinant LH (r-LH) Group B was human gonadotropin (h MG) group, and group C was high-purity h MG (HP-h MG) group. The total Gn usage, days of Gn use, number of oocytes retrieved, number of high quality embryos, number of top quality embryos, clinical pregnancy rate, live birth rate and early miscarriage rate were compared between the three groups. Results: The days of using Gn in group C were significantly lower than those in group A and group B. The total amount of Gn in group B was significantly higher than that in group A and C (P <0.05). The numbers of 2PN, cleavage, (P <0.05). There was no significant difference between group A and group C (P> 0.05). The number of top quality embryos in group C was higher than that of group A and group B Statistical significance (P <0.05). The implantation rate was 44.0% in group A, 38.2% in group B and 42.5% in group C, with no significant difference between the groups (P> 0.05). The clinical pregnancy rate and live birth rate were 62.5% and 50.6% in group A, 59.8% and 44.0% in group B, 65.3% and 52.3% in group C, respectively, but higher in group A and group C than in group B Statistical differences (P> 0.05); early abortion rate similar among the groups. CONCLUSION: Long-term follicle supplementation with LH can achieve better clinical outcomes. However, the addition of HP-h MG and r-LH can reduce the number and days of Gn use, increase the number of top-quality embryos, the clinical pregnancy rate and the live birth rate There is an increasing trend, the overall clinical outcome is better than domestic h MG.