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

• 临床研究 • 上一篇    下一篇

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. 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. 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: 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