长效GnRH-a黄体中期降调节结合HMG促排卵对卵巢子宫内膜异位囊肿患者IVF-ET妊娠结局的影响

摘要

Aim:To observe the effect of long acting GnRH-a down regulation at mid-luteal phase combined with human menopausal gonadotropin ( HMG) ovulation on the in vitro fertilization-embryo transfer (IVF-ET) outcome of patients with ovarian endometriotic cyst.Methods:A total of 230 patients with ovarian endometriotic cyst were allocated into trial group(n=98) and control group ( n = 132).The patients in trial group accepted long acting GnRH-a down regulation at mid-luteal phase combined with HMG ovulation.The patients in control group accepted short acting GnRH-a downregula-tion at mid-luteal phase combined with follicle stimulation hormone ovulation .The clinical IVF-ET outcome in the two groups was compared.Results:The LH level on the day of using Gn and the P level on the day of injecting HCG in the tri -al group was significantly lower than those in the control group (t = 5.165 ,2.307 ,P <0.05).The E2 level on the day of injecting HCG and number of oocytes retrieved in the trial group were significantly higher than those in the control group (t = 3.466 ,2.199 ,P < 0.05).Good quality embryo rate , cleavage rate , implantation rate and clinical pregnancy rate in the tri -al group were significantly higher than those in the control group (χ2=8.860 ,5.556 ,6.867 ,18.288 ,P <0.05 ).The ovarian endometriotic cysts disappeared in the trial group , while in the control group , 48 ovarian endometriotic cysts disappeared, and 84 ovarian endometriotic cysts were still existed.Conclusion: Long acting GnRH-a down regulation at mid-luteal phase plus HMG ovulation could obtain better IVF-ET outcome.%目的:探讨长效促性腺激素释放激素激动剂(GnRH-a)黄体中期降调节联合经阴道超声引导下囊肿穿刺术对卵巢子宫内膜异位囊肿体外受精-胚胎移植(IVF-ET)妊娠结局的影响.方法:选择因卵巢子宫膜内异位囊肿引起不孕行IVF-ET助孕治疗的患者230例.采用长效GnRH-a黄体中期降调节联合卵巢异位囊肿穿刺术并用人绝经期促性腺激素(HMG)促排卵98例为研究组,短效GnRH-a黄体中期降调节联合卵巢异位囊肿穿刺术并用重组人促卵泡素促排卵132例为对照组.比较2组囊肿大小的变化,降调后激素水平变化及IVF-ET妊娠的结局.结果:研究组Gn启动日LH、注射HCG日P水平明显低于对照组(t=5.165、2.307,P＜0.05),注射HCG日E2、获卵数明显高于对照组(t=3.466、2.199,P＜0.05).研究组优质胚胎率、卵裂率、种植率、临床妊娠率明显高于对照组(χ2=8.860、5.556、6.867、18.288,P＜0.05).研究组异位囊肿完全消失;对照组48个囊肿完全消失,90个囊肿仍持续存在.结论:长效GnRH-a黄体中期降调节结合HMG促排卵对卵巢子宫内膜异位囊肿引起的不孕疗效佳,可获得良好的IVF-ET妊娠结局.