HP-hMG在卵巢次高反应患者体外受精周期中的临床应用效果

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目的:探讨卵巢次高反应患者体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)周期应用高纯度尿促性素(HP-hMG,贺美奇)与重组人卵泡刺激素(r-FSH,果纳芬)促排卵的临床结局。方法:选择IVF-ET助孕的卵巢次高反应患者310例,随机分为A组和B组,分别给予r-FSH+HP-hMG(A组,n=124)和r-FSH(B组,n=186)促排卵,统计促性腺激素(Gn)总用量、Gn使用天数、获卵数、受精率、卵裂率、优质胚胎率、临床妊娠率以及因卵巢过度刺激综合征(OHSS)周期取消率及ET后OHSS发生率。结果:患者的基本情况组间无统计学差异(P>0.05),B组Gn使用天数明显多于A组(P<0.05),Gn总用量明显多于A组(P<0.05),hCG注射日E_2、LH组间无统计学差异(P>0.05),B组hCG注射日孕酮(P)值显著高于A组(P<0.05);获卵数B组显著多于A组(P<0.05),受精率、卵裂率、移植胚胎数组间无统计学差异(P>0.05),但优质胚胎率B组却显著低于A组(P<0.05),移植患者临床妊娠率组间差异无统计学意义(P>0.05),A组仅稍高于B组。A组预防OHSS周期取消率较B组明显下降(P<0.05),B组移植患者OHSS发生率略高于A组(P>0.05)。结论:在卵巢次高反应患者人群中从启动日添加HP-hMG能改善胚胎质量,增加子宫内膜容受性,降低OHSS发生率。 OBJECTIVE: To investigate the effect of high-purity urinary gonadotropin (HP-hMG) and recombinant human follicle-stimulating hormone (rHG) on in vitro fertilization-embryo transfer (IVF- -FSH, fruit Finn) ovulation clinical outcome. Methods: One hundred and three patients with sub-ovarian hyperstimulation who were assisted by IVF-ET were randomly divided into group A and group B, and were given r-FSH + HP-hMG (group A, n = 124) and r-FSH (n = 186). The total amount of gonadotropin (Gn), days of Gn use, number of oocytes retrieved, fertilization rate, cleavage rate, high quality embryo rate, clinical pregnancy rate, and ovarian hyperstimulation syndrome (OHSS) Cycle cancellation rate and OHSS after ET incidence. Results: There was no significant difference in the basic condition between the two groups (P> 0.05). The days of Gn administration in group B were significantly more than those in group A (P <0.05) (P> 0.05). The progesterone (P) value of group B on the day of hCG injection was significantly higher than that of group A (P <0.05), and the number of oocytes in group B was more than that of group A (P <0.05). There was no significant difference in fertilization rate, cleavage rate and the number of transplanted embryos (P> 0.05), but the rate of high quality embryos in group B was significantly lower than that in group A (P <0.05) The difference was not statistically significant (P> 0.05), A group was only slightly higher than the B group. The cancellation rate of OHSS in group A was significantly lower than that in group B (P <0.05). The incidence of OHSS in group B was slightly higher than that in group A (P> 0.05). Conclusion: The addition of HP-hMG from the start-up day in suboptimal ovarian patients can improve embryo quality, increase endometrial receptivity and reduce the incidence of OHSS.
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