超长方案和拮抗剂方案在PCOS患者行体外受精-胚胎移植（IVF-ET）治疗中的应用比较

摘要

目的：比较超长方案和拮抗剂方案在PCOS患者行体外受精-胚胎移植（IVF-ET）治疗中的治疗效果。方法选择2013年1月-12月在本院行第一次IVF-ET治疗的PCOS患者112例，行超长方案治疗患者61个周期为研究组，拮抗剂方案治疗患者51个周期为对照组。结果研究组的Gn天数，Gn总量明显高于对照组（P<0.05），差异有统计学意义；HCG日E2水平、获卵数、受精率、卵裂率、优胚率均无统计学差异（P>0.05）；移植日内膜厚度、种植率研究组显著高于对照组，有显著性差异（P<0.05）；HCG阳性率、临床妊娠率、OHSS发生率两组比较，虽然没有统计学差异，但研究组有明显升高的趋势；超长方案组全胚冷冻35例，未受精取消移植1例，其中因预防OHSS风险全胚冷冻30例，拮抗剂组全胚冷冻30例，胚胎发育差取消移植1例，因预防OHSS风险全胚冷冻13例。结论超长方案应用于PCOS患者，种植率和临床妊娠率明显高于拮抗剂方案，其获卵数和OHSS发生率并没有显著性差异，临床可以通过调整GN启动时间和启动剂量募集合适数量的卵泡并降低OHSS发生率，全胚冷冻也是预防OHSS风险的举措之一。%Objective To compare the application and effect of super long project and GnRH-antagnist in IVF-ET with the patiens of PCOS. Methods 112 patients with PCOS were selected and received IVF-ET in our hospital,who were randomly divid-ed into observation group(61cases) and control group(51cases),the observation group was usd super long project,the control group was used GnRH-antagnist project. Results The number of Gn days,the dosage of Gn,theendometrial thickness on the HCG in-jecting day,the implantation rate of the observation group were higher than those of control group,there were significiant differ-ence. There were no significiant difference between two groups in serum levels of E2,the number of eggs,the fertility rate,cleavage rate and premium embyo rate. The clinical rate and the rate of OHSS in the observation group were higher than that of control group but with no statistical significance. There were 35 cases freezing whole embryo in which there were 30 cases for preventing OHSS,and 1 cases Cancelled the transplant becuse of unfertilized in the observation group,There were 30 cases freezing whole embryo in which there were 13 cases for preventing OHSS,and 1 cases Cancelled the transplant becuse ofembryonic development is poor in the contr ol group. Conclusion Super long project in IVF-ET of patients with PCOS can improve the clinical pregnancy and implantation rate,but have no difference in the number of eggs and OHSS rate. we can ajust the day of start injecting Gn and the dosage of Gn to raising the right number of follicles and deduce the OHSS rate The whole embryo freezingIs also one of the measures to prevent OHSS risk.