本文選題：黃體生成素　切入點(diǎn)：長(zhǎng)方案　出處：《南方醫(yī)科大學(xué)學(xué)報(bào)》2017年11期

【摘要】：目的比較在不同人群中添加黃體生成素在長(zhǎng)方案超排卵過程中的臨床結(jié)局。方法選擇2010年6月~2015年12月在廣州市婦女兒童醫(yī)療中心生殖醫(yī)學(xué)中心進(jìn)行體外受精-胚胎移植助孕的671個(gè)周期,均使用自然周期黃體期長(zhǎng)方案促排卵,按促排卵從啟動(dòng)日是否添加重組黃體生成素(r-LH)分為A組(單用卵泡刺激素FSH)和B組(FSH+r-LH),再根據(jù)年齡是否小于35歲和啟動(dòng)日LH是否小于1.0 U/L分成4個(gè)亞組,分別比較不同亞組中是否添加LH對(duì)臨床妊娠率和種植率的影響。結(jié)果兩組患者在年齡、體質(zhì)量指數(shù)、基礎(chǔ)FSH、基礎(chǔ)LH、基礎(chǔ)雌二醇(E2)、促性腺激素劑量及天數(shù)、扳機(jī)日LH、扳機(jī)日E2、扳機(jī)日孕酮、獲卵數(shù)、受精率、每卵子可用胚胎率及優(yōu)胚率上均相似,差異無統(tǒng)計(jì)學(xué)意義,僅在扳機(jī)日內(nèi)膜厚度上差異有統(tǒng)計(jì)學(xué)意義;亞組分析顯示:對(duì)于年齡35歲且啟動(dòng)日LH1.0 U/L及年齡≥35歲且啟動(dòng)日LH≥1.0 U/L的患者,單用FSH組和FSH+r-LH組在臨床妊娠率和種植率上均相似,差異無統(tǒng)計(jì)學(xué)意義;對(duì)于年齡35歲且啟動(dòng)日LH≥1.0 U/L的患者,FSH+r-LH組臨床妊娠率60%,低于單用FSH組的臨床妊娠率79.55%,差異有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)于年齡≥35歲且啟動(dòng)日LH1.0 IU/L的患者,FSH+r-LH組的種植率為44.74%,高于單用FSH組的種植率24.74%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論在長(zhǎng)方案中,與單用FSH相比,添加LH并不提高獲卵數(shù)、受精率及每卵子優(yōu)質(zhì)胚胎率;對(duì)年齡35歲即使降調(diào)節(jié)后LH水平低或年齡≥35歲但降調(diào)后LH≥1.0 U/L者添加LH并不能使患者明顯獲益,對(duì)于年齡≥35歲且降調(diào)后LH1.0 U/L的患者添加LH可能改善臨床妊娠率和種植率,而對(duì)于年齡35歲且啟動(dòng)日≥LH1.0 U/L的患者應(yīng)慎重選擇添加外源性LH。
[Abstract]:Objective to compare the clinical outcomes of luteinizing hormone supplementation in different populations during long term hyperovulation. Methods in vitro fertilization was performed at the Reproductive Medicine Center of Guangzhou Women and Children Medical Center from June 2010 to December 2015. 671 cycles of embryo transfer. Ovulation was induced by the long luteal phase regimen. According to whether ovulation was induced by adding recombinant luteinizing hormone r-LH on the start day, group A (single follicle stimulating hormone FSHs) and group B (FSH r-LHH) were divided into four subgroups according to whether their age was less than 35 years old and whether LH was less than 1.0 U / L on the start day. Results the age, body mass index (BMI), basal FSHs, basal LHs, basal estradiol estradiol E2P, gonadotropin dose and days were compared between the two groups. LH on trigger day, E _ 2 on trigger day, progesterone on trigger day, egg number, fertilization rate, available embryo rate per egg and superior embryo rate were similar, the difference was not statistically significant, only in the thickness of intima of trigger day there was statistical significance. Subgroup analysis showed that the clinical pregnancy rate and implantation rate of FSH group and FSH r-LH group were similar to those of 35 years old and age 鈮，

本文編號(hào)：1657090