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目的探讨克罗米芬加HMG方案(CC+HMG)在卵巢低反应(poor ovarian response,POR)患者IVF/ICSI-ET周期中应用优势。方法回顾性分析IVF/ICSI—ET治疗的716个卵巢低反应周期的临床资料,按促排卵方案分为四组:CC+HMG组、长方案组、短方案组、拮抗剂组。分别统计并比较各组患者的一般情况、治疗结局及总医疗费用的差异。结果 1 CC+HMG组Gn使用量最少,与其余三组比较差异有统计学意义(P<0.05);2 CC+HMG组方案获卵数较其他方案少,周期取消率高,差异有统计学意义(P<0.05);3 CC+HMG组及长方案组较其他两组的周期累积胚胎种植率高,差异有统计学意义(P<0.05);4 CC+HMG组所需的医疗费用最低,短方案组和拮抗剂组费用接近居中,长方案最高,三者之间差异有统计学意义(P<0.05)。结论对于POR患者CC+HMG方案周期费用低,累计种植率高,而累积妊娠率和累积活产率不低于其他方案的优势,是POR患者经济实用的选择。
Objective To investigate the advantages of clomiphene citrate plus HMG regimen in IVF / ICSI-ET cycles in patients with poor ovarian response (POR). Methods The clinical data of 716 low ovarian response cycles treated with IVF / ICSI-ET were retrospectively analyzed. According to ovulation induction schedule, the patients were divided into four groups: CC + HMG group, long-course group, short-course group and antagonist group. Statistics and comparison of the general situation of patients in each group, the treatment outcome and the difference in total medical costs. Results 1 The CC + HMG group had the least amount of Gn consumption, which was significantly different from the other three groups (P <0.05). The number of oocytes retrieved in the 2 CC + HMG group was less than that in other regimens, and the cycle cancellation rate was statistically significant (P <0.05). The CCC HMG group and the long-term regimen group had a higher rate of planted embryo implantation than the other two groups (P <0.05), and the lowest CCC required for the 4 CC + HMG group (P <0.05). The cost of the short-term group and the antagonist group was close to the median and the long-term plan was the highest. The difference among the three groups was statistically significant (P <0.05). Conclusion The cost of CC + HMG regimen in POR patients is low, the cumulative implants rate is high, and the cumulative pregnancy rate and cumulative live birth rate are not lower than those of other regimens. It is an economical and practical choice for patients with POR.