【摘要】：目的 探討促性腺激素釋放激素激動(dòng)劑(GnRH-a)改良超長(zhǎng)方案促排卵中高純度尿促性素(HPhMG)不同添加時(shí)機(jī)和劑量對(duì)助孕結(jié)局的影響。方法 回顧性分析本中心首次行體外受精/卵胞質(zhì)內(nèi)單精子注射-胚胎移植(IVF/ICSI-ET)中采用改良超長(zhǎng)方案并添加使用了HP-hMG的454例患者的臨床資料,根據(jù)添加HP-hMG的時(shí)機(jī)分為全程添加組(A組)和后半期添加組(B組)。A組:Gn啟動(dòng)日血清黃體生成素(LH)1.2 IU/L的患者在重組卵泡刺激素(r-FSH)促排卵的第1日同時(shí)添加HP-hMG至hCG注射日;B組:Gn啟動(dòng)日血清LH≥1.2 IU/L的患者r-FSH促排卵的第6日開(kāi)始添加HP-hMG至hCG注射日。對(duì)不同年齡階段患者(≤35歲和36~40歲)進(jìn)行分析,觀察Gn使用總量和使用時(shí)間、hCG注射日激素水平、獲卵情況、胚胎質(zhì)量、著床率、臨床妊娠率、活產(chǎn)率、流產(chǎn)率和中重度卵巢過(guò)度刺激綜合征(OHSS)風(fēng)險(xiǎn)等臨床結(jié)果。結(jié)果 ≤35歲的患者中A組相比B組,雖然Gn使用總量有所增加,但hCG注射日孕酮(P)水平降低,IVF受精率明顯增高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);著床率分別為58.2%和42.4%,臨床妊娠率分別為80.1%和61.7%,活產(chǎn)率分別為68.9%和49.5%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。36~40歲的患者中,A組與B組的臨床妊娠率分別為61.9%和26.3%,活產(chǎn)率分別為47.6%和15.8%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。A、B兩組在不同年齡段的流產(chǎn)率和中重度OHSS發(fā)生率相似。結(jié)論 改良超長(zhǎng)方案中患者全程添加HP-hMG較后半期添加能降低hCG注射日P水平,顯著提高著床率、臨床妊娠率和活產(chǎn)率。
[Abstract]:Objective to investigate the effect of different time and dosage of high purity urotropin (HPhMG) (HPhMG) on outcome of assisted pregnancy in a modified super long protocol of gonadotropin releasing hormone agonist (GnRH-a). Methods the clinical data of 454 patients who underwent in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for the first time and were treated with HP-hMG were analyzed retrospectively. Patients with serum luteinizing hormone (LH) 1.2 IU/L) were divided into two groups according to the timing of HP-hMG addition (group A) and group B (group B) in the second half of the period. Patients with serum luteinizing hormone (LH) 1.2 IU/L) were injected with HP-hMG into hCG on the first day of ovulation induced by recombinant follicle stimulating hormone (r-FSH). On the 6th day of r-FSH ovulation in patients with LH 鈮，

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