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重组人生长激素对卵巢储备功能减退患者早发LH峰及临床妊娠结局的影响

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目的 探讨重组人生长激素(recombinant human growth hormone,rhGH)对卵巢储备功能减退患者早发促黄体生成素(luteinizing hormone,LH)峰及临床妊娠结局的影响。方法 回顾性分析2021年3月至2022年5月本院妇产科接受体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的卵巢储备功能减退患者137例。其中采用rhGH联合拮抗剂方案者为rhGH组(n=86),仅采用拮抗剂方案的患者为对照组(n=51)。对比两组患者促排卵相关指标、实验室指标和临床妊娠结局。结果 rhGH组和对照组患者的促性腺激素(gonadotropins,Gn)使用天数、绒毛膜促性腺激素(hCG)日卵泡数、hCG日P值比较,差异均无统计学意义(P>0。05),但rhGH组的Gn总量、hCG日LH值明显低于对照组(P<0。05),hCG日内膜厚度、hCG日雌二醇值高于对照组(P<0。05);rhGH组的优质胚胎率和优质胚胎数明显高于对照组(P<0。05),无可利用胚胎率和早发LH峰率明显低于对照组(P<0。05);rhGH组和对照组的平均移植胚胎数、临床妊娠率、着床率、流产率、生化妊娠率和异位妊娠率比较,差异无统计学意义(P>0。05),但rhGH组患者的胚胎种植率显著高于对照组(P<0。05)。结论 在IVF-ET助孕治疗中,添加rhGH可有效降低早发LH峰率,提高优质胚胎率和胚胎种植率,从而获得更优质胚胎和良好的妊娠结局。
Effect of recombinant human growth hormone on early onset LH peak and clinical pregnancy outcomes in ovarian reserve
Objective To explore the effects of recombinant human growth hormone(rhGH)on early onset LH peak and clinical pregnancy outcome in patients with diminished ovarian reserve function.Methods A retrospective analysis was performed on 137 patients with decreased ovarian reserve who underwent in vitro fertilization-embryo transfer(IVF-ET)in the Obsterics and Gynecology Department of our hospital from March 2021 to May 2022.Among them,the patients treated with rhGH combined with antagonist regimen were rhGH group(n=86),and the patients treated only with antagonist regimen were in the control group(n=51).Ovulation related indexes,laboratory indexes and clinical pregnancy outcomes of patients with reduced ovarian reserve were compared between the two groups.Results There was no significant difference in the days of Gn use,follicle number of hCG day and P value of hCG day between rhGH(P>0.05),but the total Gn and LH value of hCG day in rhGH were significantly lower(P<0.05).The intima thickness and E2 value of hCG day were higher(P<0.05).The high quality embryo rate and number of high-quality embryos in rhGH noticeably higher than those(P<0.05),and the peak rate and embryo rate of unusable early onset LH were noticeable(P<0.05).The average number of transplanted embryos,pregnancy rate of rhGH had no statistical significance(P>0.05),but the embryo implantation rate of rhGH was noticeably higher(P<0.05).Conclusions In IVF-ET treatment,adding rhGH can effectively reduce LH peak rate,improve high-quality embryo rate and embryo implantation rate,thereby obtaining higher-quality embryos and embryo implantation rate.

decreased ovarian reserve functionrecombinant human growth hormoneearly onset LH peakpregnancy outcome

许英、王晔、陈颖

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同济大学附属妇产科医院妇产科,上海 201204

卵巢储备功能减退 重组人生长激素 早发促黄体生成素峰 妊娠结局

2024

中国妇产科临床杂志
北京大学

中国妇产科临床杂志

CSTPCD北大核心
影响因子:1.095
ISSN:1672-1861
年,卷(期):2024.25(6)