改良超长降调节方案在体外受精-胚胎移植中的应用

摘要

目的：探讨改良超长降调节方案结合人绝经期促性腺激素（HMG）在体外受精-胚胎移植（IVF-ET）中的应用。方法对一次降调不全患者采用改良超长方案降调节，行IVF-ET的49例患者（50周期）作为试验组（A组），随机选择同期常规长方案降调节行IVF-ET的46例患者（51周期）作为对照组（B组）。比较两组间年龄、不孕时间、IVF周期数、总AFC数、启动Gn剂量、Gn天数、Gn总量、获卵数、MII率、受精率、卵裂率、优质胚胎率、流产率、总药费支出。结果两组间患者年龄、不孕时间、IVF周期数、总AFC数、Gn天数、Gn总量、获卵数、MII率、受精率、卵裂率、优质胚胎率、流产率差异无统计学意义（P＞0．05）；启动Gn剂量A组大于B组，差异有统计学意义（P＜0．05）。总药费支出 A 组小于 B 组，差异有统计学意义（P＜0．05）；妊娠率 A 组（56．00％）大于B组（45．10％），但是差异无统计学意义（P＞0．05）。结论改良超长降调节结合HMG促排卵对一次降调不全的IVF-ET患者可以得到较理想的妊娠结局，并明显降低费用。%Objective To explore the application of the modified super-long down-regulation protocol combined with human menopa-usal gonadotrophin(HMG)in IVF-ET for patients.Methods We selected 49 patients(50 cycles)who were applied of modified super-long because of insufficiency down-regulation undergoing IVF-ET as experimental group.We randomly selected 46 patients(51 cycles)who accept-ed conventional long down-regulation protocol as control group(Group B).Age of patients,time of infertility,number of IVF cycles,total antral follicle count,the starting does of gonadotropin,days of gonadotropin,total amps of gonadotropin,number of retrieved oocytes,MⅡoocytes rate,fertilization and cleavage rate,high quality embryos rate,clinical pregnancy and miscarriage rate were compared between the two groups. Results Between the two groups,there were no significant differences in age of patients,time of infertility,number of cycles,total antral folli-cle count,days of gonadotropin,total amps of gonadotropin,number of retrieved oocytes,MⅡoocytes rate,fertilization and cleavage rate,high quality embryos rate and miscarriage rate (P>0.05).The starting dose of gonadotropin in group A was statistically higher than that in group B(P<0.05).The total cost of drugs of group A was statistically less than that of group B(P<0.05).The clinical pregnancy rate of group A (56.00%)was statistically higher than that of group B(45.1 0%).Conclusion Modified super-long down-regulation protocol combined with HMG ovulation induction can achieve an ideal results in patients with insufficiency down-regulation,and can significantly reduce the cost as well.