首页|两种重组人卵泡刺激素注射液在不同人群中的促排卵效果分析

两种重组人卵泡刺激素注射液在不同人群中的促排卵效果分析

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目的 探究具有不同糖修饰谱的两种重组人卵泡刺激素(rFSH)在不同人群中行控制性促排卵(COH)临床应用的有效性和安全性。方法 回顾性分析2022年1-12月期间本中心的320个COH周期的临床资料,按照COH中使用的rFSH种类不同分为A组(芳乐舒®,95个周期)和B组(Puregon®,225个周期)。比较两组患者在起始剂量、刺激时间、HCG 日激素水平和内膜厚度、获卵数、减数分裂Ⅱ期(MⅡ)卵率、受精率、卵裂率、有效胚胎率、卵母细胞利用率和胚胎利用率等方面的差异。结果 在A、B两组患者的年龄[(34。9±4。9)岁vs。(33。3±4。5)岁,P=0。006]、体质量指数(BMI)[(22。5 ±3。2)kg/m2 vs。(21。6±2。6)kg/m2,P=0。027]存在一定差异的前提下,A 组获卵数与 B 组相当[(11。2±7。0)vs。(12。9± 7。3),P=0。059]。在拮抗剂方案COH周期,两组患者年龄相近(P>0。05),此时两组的获卵数[(13。7±7。1)vs。(14。8± 7。6),P=0。340]及其他结局指标均无统计学差异(P>0。05)。将所有患者根据年龄分层分析,高龄(≥35岁)亚组中,A组患者受精率[(78。1±19。6)%vs。(69。1±25。8)%,P=0。039]、卵裂率[(98。9±3。2)%vs。(93。7±22。1)%,P=0。039]和卵母细胞利用率[(44。9±30。6)%vs。(34。1±23。5)%,P=0。037]显著高于B组;低龄(<35岁)亚组中,A、B两组患者各项结局指标均无统计学差异(P>0。05)。通过逐步多元回归分析,确定COH方案和年龄是获卵数的预测因素(P<0。001),最终回归模型可解释28。8%的反应变异性。结论 芳乐舒®与Puregon®两种rFSH具有相似的获卵数和获胚结局,在高龄人群中芳乐舒®诱导的卵母细胞质量可能较高。
Analysis of ovulation induction effects of two kinds of recombinant human follicle-stimulating hormone injections among different patients
Objective:To investigate the efficacy and safety of two kinds of recombinant human follicle-stimulating hormone(rFSH)with different glycan modification profiles for clinical use among different patients undergoing controlled ovulation hyperstimulation(COH).Methods:Clinical data from a total of 320 cycles of COH using Follitrope® or Puregon® between January 2022 and December 2022 at Reproductive Medicine Center of Zhongshan Hospital,Fudan University were retrospectively analyzed.According to the type of rFSH used in COH,patients were divided into group A(Follitrope®,95 cycles)and group B(Puregon®,225 cycles).The differences between the two groups were compared in terms of starting doses of rFSH,duration of treatment,levels of hormones and endometrial thickness on HCG day,number of oocytes retrieved,metaphase[[oocyte rate,the fertilization rate,the cleavage rate,effective embryo rate,oocyte utilization rate and embryo utilization rate.Results:The number of oocytes retrieved in group A was comparable to that of group B[(11.2±7.0)vs.(12.9±7.3),P=0.059],provided that there were some differences between the two groups in terms of age[(34.9±4.9)years old vs.(33.3±4.5)years old,P=0.006],BMI[(22.5±3.2)kg/m2 vs.(21.6± 2.6)kg/m2,P=0.027)].In the antagonist COH cycles,the age was similar between the two groups(P>0.05),and there was no statistical differences in the outcome indicators such as the number of oocytes retrieved[(13.7±7.1)vs.(14.8±7.6),P=0.340].All patients were further divided into older subgroups(≥35 years old)and younger subgroups(<35 years old).In the older subgroup,the fertilization rate[(78.1±19.6)%vs.(69.1±25.8)%,P=0.039],the cleavage rate[(98.9±3.2)%vs.(93.7± 22.1)%,P=0.039],and oocyte utilization rate[(44.9±30.6)%vs.(34.1±23.5)%,P=0.037]of group A were significantly higher than those of group B.In the younger subgroup,there were no significant differences in various indicators(P>0.05)between group A and group B.The COH protocol and age were identified as predictors of the number of oocytes acquired by stepwise multiple regression analysis(P<0.001),explaining 28.8%of the response variability.Conclusions:Similar oocytes and embryo retrieval outcomes were found when compared Puregon® to Follitrope®,but the quality of oocytes induced by Follitrope® would be higher in older patients.

Recombinant human follicle-stimulating hormoneControlled ovarian hyperstimulationAdvanced ageGlycosylation

季晓微、贺立颖、陈玮、王琳、刘淼、刘素英、董曦

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复旦大学附属中山医院生殖医学中心,上海 200032

重组人卵泡刺激素 控制性促排卵 高龄 糖基化

2024

生殖医学杂志
北京协和医院 国家人口计生委科学技术研究所

生殖医学杂志

CSTPCD
影响因子:1.24
ISSN:1004-3845
年,卷(期):2024.33(4)
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