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目的探讨各种不同体外受精(IVF)助孕方案对子宫腺肌病伴不孕症患者的疗效。方法对2006年1月-2009年6月进行IVF助孕治疗的子宫腺肌病伴不孕症患者63例的临床资料进行回顾性分析。根据是否应用长效促性腺激素释放激素激动剂(GnRH-a)及启动促性腺激素(Gn)时间分为超长方案、长效GnRH-a后长或短方案、常规长方案3组,对IVF助孕疗效进行分析。结果 3种治疗方案的Gn刺激天数、Gn总量、获卵数、不良反应发生率和流产率比较无统计学意义(P>0.05);3种治疗方案的周期取消率为20.0%、7.7%、30.0%,比较有统计学意义(χ2=5.74,P<0.05),方案2的周期取消率低于方案1和方案3,有统计学意义(χ2=7.21,P<0.05);3种治疗方案的继续妊娠率为23.0%、37.0%、15.3%,有统计学意义(χ2=11.31,P<0.05),方案2的继续妊娠率高于方案1和方案3,有统计学意义(χ2=8.52,P<0.05)。结论与超长方案和常规长方案相比,子宫腺肌病伴不孕症患者采用长效GnRH-a治疗后长方案或短方案行IVF助孕治疗,妊娠率升高,周期取消率降低。
Objective To investigate the efficacy of various in vitro fertilization (IVF) pregnancy programs on patients with adenomyosis and infertility. Methods The clinical data of 63 cases of adenomyosis with infertility who underwent IVF assisted pregnancy from January 2006 to June 2009 were analyzed retrospectively. According to whether the use of long-acting gonadotropin-releasing hormone agonist (GnRH-a) and start gonadotropin (Gn) time is divided into long program, long or short GnRH-a long or short program, the conventional long program 3 groups, IVF assisted pregnancy analysis. Results There was no significant difference in Gn stimulation days, Gn counts, number of oocytes retrieved, incidence of adverse reactions and miscarriage among the three treatment regimens (P> 0.05). The cycle cancellation rates of the three treatment regimens were 20.0% and 7.7% , 30.0% respectively (χ2 = 5.74, P <0.05). The cancellation rate of scheme 2 was lower than that of scheme 1 and scheme 3 (χ2 = 7.21, P <0.05) The follow-up pregnancy rates were 23.0%, 37.0% and 15.3% respectively (χ2 = 11.31, P <0.05). The continued pregnancy rate of scheme 2 was higher than that of schemes 1 and 3 (χ2 = 8.52, P <0.05). Conclusion Compared with long-term and long-term regimens, patients with adenomyosis and infertility treated with long-term GnRH-a long-term or short-course IVF assisted pregnancy have higher pregnancy rates and lower revocation rates.