摘要
目的 比较卵巢低反应(POR)患者微刺激方案与拮抗剂方案的促排卵结局和妊娠临床结局.方法 选取医院 2016 年 3 月至2022年1月接受微刺激方案和拮抗剂方案的POR患者 371例,取卵周期中按治疗方案不同分为微刺激组(185例)和拮抗剂组(186例).比较两组体外授精-胚胎移植(IVF-ET)助孕过程中的促排卵结局[促性腺激素(Gn)用量、Gn使用时间、获卵总数、2PN数、可移植胚胎数、优质胚胎数]和妊娠临床结局(周期取消率、临床妊娠率、生化妊娠率、双胎率、流产率、活产率).结果 微刺激组的抗缪勒管激素(AMH)水平、Gn用量、Gn使用时间、获卵总数、2PN数、可移植胚胎数均显著低于拮抗剂组(P<0.01).微刺激组周期取消率为83.24%,显著高于拮抗剂组的 66.67%(P<0.01).微刺激组临床妊娠率高于拮抗剂组,但差异无统计学意义(48.39%比 40.32%,P>0.05).结论 微刺激方案可减少POR患者Gn的用量和使用时间,临床妊娠率稍高,可能是更可行的方案.但周期取消率高,需结合患者的卵巢功能进行选择.
Abstract
Objective To compare the effects of micro-stimulation and antagonist on ovulation induction outcomes and clinical pregnancy outcomes in patients with poor ovarian response(POR).Methods A total of 371 patients with POR who received micro-stimulation and antagonist in the hospital from March 2016 to January 2022 were selected and divided into micro-stimulation group(185 cases)and antagonist group(186 cases)according to different treatment regimens during the ovulation cycle.The ovulation induction outcomes[amount of gonadotropins(Gn),Gn use time,total number of harvest eggs,number of 2PN,number of transplantable embryos,and number of high-quality embryos]and clinical pregnancy outcomes(cycle cancellation rate,clinical pregnancy rate,biochemical pregnancy rate,twin rate,abortion rate,and live birth rate)during in vitro fertilization-embryo transfer(IVF-ET)assisted pregnancy were compared between the two groups.Results The anti-mullerian hormone(AMH),the amount of Gn and Gn use time,total number of harvest eggs,number of 2PN,and number of transplantable embryos in the micro-stimulation group were significantly lower than those in the antagonist group(P<0.01).The cycle cancellation rate in the micro-stimulation group was 83.24%,which was significantly higher than 66.67%in the antagonist group(P<0.01).The clinical pregnancy rate in the mioro-stimulation group was lower than that in the antagonist group,without significant difference(48.39%vs.40.32%,P>0.05).Conclusion Micro-stimulation can reduce the dosage and duration of Gn in patients with POR,with a slightly higher clinical pregnancy rate,which may be a more feasible plan.However,the cancellation rate of the cycle is high,and the selection needs to be based on the patient's ovarian function.
基金项目
安徽省合肥市第七周期临床重点(培育)专科建设项目(合卫医秘[2023]72号)
安徽省高等学校科学研究重点项目(2022AH050785)
安徽省合肥市2022年度第三批市关键共性技术研发项目(GJ2022SM09)
安徽省合肥市"借转补"基金项目(J2018Y03)
维普
万方数据