生长激素对不同年龄卵巢储备功能趋于低下患者IVF-ET治疗结局的影响

摘要

Objective: To discuss whether growth hormone (GH) positively affect the IVF outcome of patients with decreased ovarian reserve at different age. Methods: Two hundred and forty infertile patients with decreased ovarian reserve (basal FSH 10.0-15.0 mlU/ml) were enrolled into our study and divided into two parts according to the age of 35 year-old, each part was further divided into two groups by having used GH in their cycles or not. Patients received GH were taken as GH group, while those didn't were taken as control group. All the patients had been down-regulated according to the conventional long protocol in our centre. Ovarian response and outcomes of IVF were observed in both groups. Results: The group less than 35 years old included GH group with 81 cases and control group with 90 cases. The group equals to or more than 35 years old included GH group with 39 cases and control group with 30 cases. Effect of GH on patients under 35 years old with diminished ovarian reserve was as follows: no significant difference was observed in the dosage of Gn, its duration, the level of estradiol, the number of retrieved ovum, 2PN fertilization rate, good-quality embryo rate, implantation rate and clinical rate between the two groups (all P>0.05). Effect of GH on patients equals to or more than 35 years old with diminished ovarian reserve was as follows: The dosage of Gn was significantly lower (P<0.05), and its duration was shorter in GH group than those in the control. The level of estradiol and the number of retrieved ovum were significantly higher (P<0.05) in GH group than those in the control. Conclusion: GH has no significant effect on the ovarian response and IVF outcome for the patients less than 35 years old with decreased ovarian reserve. GH may diminish the dosage of Gn, elevate the level of estradiol on the day of hCG injection and increase the number of retrieved ovum for the patients equal to or more than 35 years old with decreased ovarian reserve.%目的:探讨生长激素(GH)对不同年龄卵巢储备功能趋于低下患者在IVF-ET中是否有影响.方法:行IVF-ET的卵巢储备功能趋于低下的不孕患者240例,均采用普通长方案降调节.观察不同年龄患者加用GH后的卵巢反应,并以不加用GH者为对照组.结果:年龄＜35岁GH组81例,对照组90例;年龄≥35岁GH组39例,对照组30例.年龄＜35岁的不孕症患者Gn使用天数、Gn使用支数、hCG注射日E2水平、获卵数、2PN受精率、优质胚胎率、种植率、妊娠率等观察指标,对照组和GH组间均无统计学差异(P＞0.05).年龄≥35岁的不孕症患者Gn用量(Gn支数)实验组显著低于对照组,有统计学差异(P＜0.05); hCG注射日E2水平、获卵数实验组显著高于对照组,差异有统计学意义(P＜0.05).结论:GH对年龄＜35岁卵巢储备功能低下患者的卵巢反应及IVF-ET治疗结局无影响；而对年龄≥35岁则有一定影响,可减少Gn使用量,提高hCG注射日的E2水平,增加获卵数.