促性腺激素释放激素拮抗剂在超促排卵中的应用

摘要

Objective: To analyze the clinical characteristics and outcomes of gonadotropin releasing hormone antagonist (GnRH-ant) protocol in controlled ovarian hyperstimulation for the patients of advanced age.Methods: Two hundred and thirty-three GnRH-ant protocol cycles, 50 GnRH agonist (GnRH-a) short protocol cycles and 253 GnRH-a long protocol cycles for the patients aged 35-42 years in this center were analyzed retrospectively. The total dose and duration of gonadotropin (Gn) administration, number of retrieved oocytes, fertility rate, cleavage rate, good-quality embryo rate and clinical pregnancy rate were compared between these three groups.Results: There was no significant difference in age of patients between these three groups. Compared with those of GnRH-a long protocol, the ampules of Gn used were fewer and duration of Gn administration was shorter in GnRH-ant protocol and GnRH-a short protocol (P<0. 05). There was no statistical difference in number of retrieved oocytes, fertility rate, cleavage rate, good-quality embryo rate and clinical pregnancy rate among these three groups (P>0. 05).Conclusions: GnRH-ant protocol could reduce the dose of Gn used and shorten the duration of Gn administration in the patients of advanced age without compromising the clinical pregnancy rate, when compared with GnRH-a long protocol.%目的 分析在高龄患者的体外受精-胚胎移植周期中应用促性腺激素释放激素拮抗剂(GnRH-ant)方案的临床特征和治疗结局. 方法 回顾性分析233个GnRH-ant移植周期、50个促性腺激素激动剂(GnRH-a)短方案移植周期和253个GnRH-a长方案移植周期患者的促性腺激素(Gn)用药天数和剂量、获卵数、受精率、卵裂率、优质胚胎率和临床妊娠率等差异. 结果 与GnRH-a长方案组相比,GnRH-ant方案组和GnRH-a短方案组超促排卵时间相对较短,Gn用量较少,而后两组之间无明显差异.三组之间获卵数、受精率、卵裂率、优质胚胎数和临床妊娠率均无统计学差异(P＞0.05). 结论 与GnRH-a长方案组相比,在高龄患者应用GnRH-ant方案能缩短促排卵时间,减少Gn用量,而不影响临床妊娠率.