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目的探讨1/4支与1/2支长效曲普瑞林在体外受精-胚胎移植中的治疗效果。方法 290个长方案周期,根据基础窦卵泡数分为A组(<15个)和B组(≥15个),两组内比较1/4支与1/2支长效曲普瑞林的治疗效果。结果促性腺激素(Gn)使用天数,两剂量无差异;Gn用量为1/4支组少于1/2支组,在A组有统计学意义(P<0.05);hCG注射日血清LH水平为1/4支组高于1/2支组,无统计学意义,均无早发LH峰;hCG注射日血清E2为1/4支组显著高于1/2支组(P<0.001),hCG注射日血清P水平为1/4支组高于1/2支组,胚胎种植率为1/4支组低于1/2支组,均在A组有统计学意义(P<0.05);卵巢过度刺激综合症发生率为1/4支组高于1/2支组,在B组有统计学意义(P<0.001);获卵数、正常受精数、优质胚胎数、妊娠率及流产率两剂量均无统计学意义。结论 1/4支和1/2支曲普瑞林均能达到可控制性超促排卵的降调效果;1/4支曲普瑞林在基础窦卵泡较少(<15个)时能减少Gn用量;1/2支曲普瑞林在基础窦卵泡较多时(≥15个)能充分降调节,并能避免血清E2过高,减少卵巢过度刺激的风险,因此降调节时减少GnRHa的用量应当个体化。
Objective To investigate the curative effect of 1/4 and 1/2 long-acting triptorelin in in vitro fertilization-embryo transfer. Methods A total of 290 long-term cycles were divided into group A (n = 15) and group B (n = 15) based on the number of basal antral follicles. In the two groups, 1/4 and 1/2 long-acting triptorelin treatment effect. Results There was no difference in the number of days of gonadotropin (Gn) administration between the two groups. The dosage of Gn was less than 1/4 in group A, with statistical significance in group A (P <0.05) 1/4 group was higher than 1/2 group, no statistical significance, no early onset LH peak; serum E2 on the day of hCG injection was significantly higher than the 1/4 group than in the 1/2 group (P <0.001) , the level of serum P on the day of hCG injection was higher than that in the ¢ ôgroup and the rate of embryo implantation was less than ¢ ò in the ¢ ¼group (all P <0.05) ). The incidence of ovarian hyperstimulation syndrome was higher in the ¼ branch group than in the ½ branch group, with statistical significance in group B (P <0.001); number of oocytes retrieved, number of normal fertilization, number of high quality embryos, pregnancy rate And abortion rate of two doses were not statistically significant. Conclusions Both 1/4 and 1/2 triptorelin can achieve the effect of controlled ovarian hyperstimulation. The 1/4 triptorelin can be reduced when there are fewer (> 15) basal antral follicles Gn dosage; 1/2 triptorelin in the more basic follicles (≥ 15) can be fully down regulation, and to avoid excessive serum E2, reducing the risk of ovarian hyperstimulation, so reducing the amount of reduced GnRHa Should be individualized.