首页|生长激素协同高孕激素促排卵方案对低预后女性体外受精结局的影响

生长激素协同高孕激素促排卵方案对低预后女性体外受精结局的影响

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目的 旨在探讨生长激素(growth hormone,GH)协同高孕激素促排卵(progesterone-primed ovarian stimulation,PPOS)方案对低预后妇女体外受精(in vitro fertilization,IVF)结局的影响.方法 本研究使用倾向评分匹配(propensity score matching,PSM)分析的回顾性队列研究.对 2017 年 1 月至 2021 年 12 月期间IVF治疗的女性进行回顾分析.结果 在PSM后,76 对IVF结果低预期女性纳入分析.结果 显示,与对照组相比,GH协同治疗组的可移植胚胎率升高(P<0.001),获卵数、metaphase Ⅱ(MⅡ)卵率、D1-two-pronuclear(2PN)受精率、优质胚胎比率、临床妊娠率、促性腺激素(gonadotropin,Gn)用量和天数、雌二醇(estradiol,E2)峰值差异无统计学意义.亚组分析显示卵巢储备功能减退女性应用GH可移植胚胎率升高(P=0.010),40 岁以下女性MⅡ卵率(P=0.010)和可移植胚胎率(P<0.001)升高.结论 体外受精中,GH对卵母细胞质量和PPOS方案的可移植胚胎率可能存在提高作用,其辅助给药可作为低预后妇女的可选治疗策略.
Effects of growth hormone co-treatment with progesterone-primed ovarian stimulation protocol on IVF outcomes in women with low prognosis
Objective To study the effect of growth hormone(GH)with progesterone-primed ovarian stimulation(PPOS)protocol on in vitro fertilization(IVF)outcomes among women with low prognosis.Methods This is a retrospective cohort study using propensity score matching(PSM)analysis.Women commencing their IVF between January2017 to December2021,with and without GH co-treatment,were reviewed.Results After PSM,76 pairs of women with low prognosis were included into analysis.Paired testing showed there is a statistical increase in transferable embryo(P<0.001)in the GH co-treatment group comparing with control group.No significant difference showed in retrieved oocyte number and metaphaseⅡ(MⅡ)oocyte rate,two-pronuclear(2PN)zygote rate on day1,high-quality embryo rate,or clinical pregnancy rate,neither in gonadotropin(Gn)requirement,duration or peak estradiol.Subgroup analysis results showed transferrable embryo rate on day3 rising among decreased ovarian reserve women(P=0.010).For women aged below 40,MⅡoocyte rate(P=0.010)and transferrable embryo rate on day3(P<0.001)increased in GH co-treatment group.Conclusions GH is suggested a beneficial impact on oocyte quality and transferrable embryos with PPOS protocol in IVF.Its adjuvant administration can be proposed as an optional therapeutic strategy in women with low prognosis.

Growth hormoneIn vitro fertilizationProgesterone-primed ovarian stimulationLow prognosisPropensity score matching

张加能、张焕焕、王冲

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杭州市妇产科医院生殖内分泌中心,浙江杭州 310000

生长激素 体外受精 高孕激素促排卵 低预后 倾向得分匹配

浙江省医药卫生科技计划项目

2022486978

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(5)
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