不同促排卵方案对多囊卵巢综合征不孕高龄患者妊娠结局的影响

摘要

Objective To investigate the effects of different ovulation inducing schemes on pregnancy outcomes of infertile women with polycystic ovary syndrome.Methods A retrospective analysis was made on the clinical data of 346 cycles in infertile women with polycystic ovary syndrome who underwent in vitro fertilization-embryo transfer in our hospital from January 2013 to May 2015,and were divided into control group (gonadotropin-releasing hormone agonists,n=175) and research group (gonadotropin-releasing hormone antagonists,n=171),the pregnancy outcomes were compared between the two groups.Results In the control group,108 patients completed the transfer cycle,the cycle completion rate was 61.71％,and 101 patients completed the transfer cycle in the research group,the cycle completion rate was 59.06％,there was no statistically significant difference in the rate of cycle completion between the two groups (x 2=0.245,P＞0.05).The drug dosage of the control group was lower than that of the research group,and the time of treatment was shorter than that of the research group,but there were no statistically significant differences between the two groups (P＞0.05).There were no statistically significant differences in the number of retrieved oocytes,the number of qualified oocytes,the number of transplantable embryos,and the number of high quality embryos between the two groups (P＞0.05).In the patients who completed the transfer cycle,the clinical pregnancy rate of the study group was lower than that of the research group (P＜0.05),there were no statistically significant differences in the rate of biochemical pregnancy and the rate of abortion between the two groups (P＞0.05).Conclusion Gonadotropin-releasing hormone antagonists have better clinical pregnancy rate in infertile women with polycystic ovary syndrome,which should be the first choice to promote ovulation.%目的 探讨不同促排卵方案对多囊卵巢综合征不孕高龄患者妊娠结局的影响.方法 对2013年1月至2015年5月在本院首次行体外受精-胚胎移植的多囊卵巢综合征高龄不孕女性346例周期临床资料进行回顾性分析,按促排卵方案分为对照组(促性腺激素释放激素激动剂短方案,n=175)与研究组(促性腺激素释放激素拮抗剂方案,n=171),比较两组患者妊娠结局.结果 对照组共108例患者完成移植周期,周期完成率为61.71％,研究组共101例患者完成移植周期,周期完成率为59.06％,两组患者周期完成率比较,差异无统计学意义(x2=0.245,P＞0.05).对照组患者药物用量较研究组低,治疗时间较研究组短,但组间比较差异无统计学意义(P＞0.05).两组患者获卵数、合格卵数、可移植胚胎数及优质胚胎数比较,差异无统计学意义(P＞0.05).完成移植周期的患者中,对照组患者临床妊娠率低于研究组,差异有统计学意义(P＜0.05).生化妊娠率及流产率组间比较,差异无统计学意义(P＞0.05).结论 拮抗剂方案治疗多囊卵巢综合征不孕高龄患者时临床妊娠率较高,应作为促排卵方案的首选.