卵巢功能储备正常者拮抗剂方案COH使用过程中添加高纯度人绝经促性腺激素对IVF-ET妊娠结局的影响

doi:10.13481/j.1671-587x.20180527

吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (05): 1036-1040.doi: 10.13481/j.1671-587x.20180527

卵巢功能储备正常者拮抗剂方案COH使用过程中添加高纯度人绝经促性腺激素对IVF-ET妊娠结局的影响

马亚兰¹, 张欣², 李丹丹¹, 周鹤¹, 房书珈¹, 徐影¹, 郑连文¹

1. 吉林大学第二医院妇产科生殖中心, 吉林长春 130041;
2. 吉林大学第二医院麻醉科, 吉林长春 130041

收稿日期:2018-01-29 出版日期:2018-09-28 发布日期:2018-11-20
通讯作者: 徐影,主治医师(Tel:0431-88796604,E-mail:30245188@qq.com);郑连文,教授,主任医师,博士研究生导师(Tel:0431-88796604,E-mail:davezheng@sohu.com) E-mail:30245188@qq.com;davezheng@sohu.com
作者简介:马亚兰(1993-),女,山东省济宁市人,在读医学硕士,主要从事妇产科辅助生殖方面的研究。
基金资助:
吉林省卫计委卫生技术项目资助课题（2017J054）

Influence of high-purity human menopausal gonadotropin added in process of antagonist program COH in IVF-ET pregnancy outcome in patients with normal ovarian function reserve

MA Yalan¹, ZHANG Xin², LI Dandan¹, ZHOU He¹, FANG Shujia¹, XU Ying¹, ZHENG Lianwen¹

1. Reproductive Center, Department of Obstetrics and Gynecology, Second Hospital, Jilin University, Changchun 130041, China;
2. Department of Anesthesiology, Second Hospital, Jilin University, Changchun 130041, China

Received:2018-01-29 Online:2018-09-28 Published:2018-11-20

摘要/Abstract

摘要： 目的：探讨卵巢功能储备正常者应用拮抗剂方案体外受精控制性超促排卵（COH）不同阶段添加高纯度人绝经促性腺激素（HP-hMG）对体外受精-胚胎移植（IVF-ET）妊娠结局的影响，阐明其可能的作用机制。方法：选取接受体外受精（IVF）治疗的25~40岁卵巢储备功能正常患者142例，采用回顾性分析的方法根据HP-hMG添加时机分为早期添加组（第1天添加HP-hMG）和中晚期添加组（第6天添加HP-hMG），分析2组患者的妊娠结局。结果：与早期添加组比较，中晚期添加组患者人绒毛膜促性腺激素（HCG）注射日雌二醇（E2）水平升高（P=0.042），孕酮（P）水平升高（P=0.016），直径 > 16 mm及直径 > 18mm的卵泡数增加（P=0.035，P=0.026）；与早期添加组比较，中晚期添加组患者成熟卵率、优质胚胎率和累积妊娠率升高（P=0.006，P=0.001，P=0.040）。结论：卵巢功能储备正常者应用拮抗剂方案COH时，在中晚卵泡期添加HP-hMG可改善累积妊娠结局。

关键词: 高纯度人绝经期促性腺激素, 拮抗剂方案, 体外受精-胚胎移植, 妊娠结局

Abstract: Objective:To investigate the influence of high-purity human menopausal gonadotrophin (HP-hMG) added in different periods of antagonist program COH in the pregnancy outcom of in vitro fertilization-embryo transplantation (IVF-ET) of the patients with normal ovarian function reserve,and to clarify the possible mechanism. Methods:A totol of 142 patients aged from 25 to 40 years old with normal ovarian function underwent IVF treatment were selected.According to the timing of HP-hMG addition,they were divided into early addition group (HP-hMG was added on the first day) and middel and latel addition group (HP-hMG was added on the 6th day).The pregnancy outcomes of the patients were analyzed. Results:Compared with early addition group, the estradiol(E2) level on the day of human chorimic gonadotropin(HCG) injection in middle and late addition group was significantly increased (P=0.042) and the progesterone(P) level on the day of HCG injection was significantly decreased(P=0.016), the number of follicles with diameter > 16 mm (P=0.035) and the number of follicles with diameter > 18 mm(P=0.026) were increased.Compared with early addition group,the rate of mature follicles in middle and late addition group was increased (P=0.006),the rate of high quality embroy was increased (P=0.001),and the cumulative pregnancy rate was increased (P=0.040). Conclusion:The addition of HP-hMG at middle and late follicular phase can improve the pregnancy outcome in the patients with normal ovarition function reserve under went antagonist program COH.

Key words: high purity human menopausal gonadotropin, antagonist regime, in vitro fertilization-embryo transplantation, pregnancy outcome

中图分类号:

R711.75

马亚兰, 张欣, 李丹丹, 周鹤, 房书珈, 徐影, 郑连文. 卵巢功能储备正常者拮抗剂方案COH使用过程中添加高纯度人绝经促性腺激素对IVF-ET妊娠结局的影响[J]. 吉林大学学报(医学版), 2018, 44(05): 1036-1040.

MA Yalan, ZHANG Xin, LI Dandan, ZHOU He, FANG Shujia, XU Ying, ZHENG Lianwen. Influence of high-purity human menopausal gonadotropin added in process of antagonist program COH in IVF-ET pregnancy outcome in patients with normal ovarian function reserve[J]. Journal of Jilin University(Medicine Edition), 2018, 44(05): 1036-1040.

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卵巢功能储备正常者拮抗剂方案COH使用过程中添加高纯度人绝经促性腺激素对IVF-ET妊娠结局的影响

Influence of high-purity human menopausal gonadotropin added in process of antagonist program COH in IVF-ET pregnancy outcome in patients with normal ovarian function reserve

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