【摘要】 目的比较体外受精-胚胎移植（IVF-ET）周期中使用不同卵泡刺激素（FSH）方法的效果及成本效果比。方法回顾性分析2011年1月～2011年7月在我院生殖医学中心行体外受精/卵细胞浆内单精子注射（IVF/ICSI）长方案治疗的不孕症患者共267个治疗周期,根据FSH不同使用方法分三组,A组[重组卵泡刺激素（rFSH）果纳芬组]112例、B组[rFSH+高纯度尿卵泡刺激素（uFSH-HP）,果那芬+丽申宝组]102例、C组（uFSH-HP,丽申宝组）53例。比较三组患者促排卵时间、促性腺激素（Gn）总量、人绒毛膜促性腺激素（hCG）注射日雌激素水平、子宫内膜厚度、获卵数、受精率、卵裂率、可移植胚胎数、移植周期临床妊娠率、种植率、流产率、中重度卵巢过度刺激综合征（OHSS）发生率及促排卵药品费用。结果三组促排卵天数、Gn总量、hCG注射日雌二醇（E₂）水平和子宫内膜厚度、平均获卵数、受精率、卵裂率、可移植胚胎数、流产率差异无显著性（P>0.05）,B组移植周期临床妊娠率、种植率显著高于其余二组,差异有显著性（P<0.05）,A组中重度OHSS发生率明显高于其余二组,差异有显著性（P<0.01）。计算成本效果比,A、B、C组每获得1枚可利用胚胎的促排卵药品费用分别为961.4、990.9、735.9元。结论在IVF-ET周期,rFSH、uFSH-HP超排卵效果相当;当两种药物联合应用时,可取得更好的超促排卵效果,rFSH易使OHSS发生率增高,取得相同效果时使用rFSH组和rFSH+uFSH-HP联合应用组所需成本相当,使用uFSH-HP成本最低。更多还原

【Abstract】 Objective:To compare the effect and the cost-effectiveness of different follicle stimulating hormone regimen of in vitro fertilization embryo-transfer(IVF-ET). Methods:A total of 267 IVF/ICSI-ET cycles in infertility patients who received their treatment in our reproductive center from January to July 2011 were analyzed retrospectively.They were divided into three groups according to FSH used:112 in group A(Gonal-F group),102 in group B(Gonal-F + Urofollitropin group) and 53 in group C(Urofollitropin group).The duration of stimulation,total gonadotropin dose,estradiol levels and endometrial thickness on hCG day,numbers of retrieved oocytes, fertilization rate,cleavage rate,embryo transferable,clinical pregnancy rate per embryo transfer cycle, implantation rate,abortion rate,moderate-severe OHSS rate and gonadotropin cost per cycle were compared among the three groups. Results:The duration of stimulation,total gonadotropin dose,estradiol level and endometrial thickness on hCG day,numbers of retrieved oocytes,fertilization rate,cleavage rate,embryo transferable,abortion rate did not significantly different among the three groups.The moderate-severe OHSS rate in group A was significantly higher than that in the other two groups.The clinical pregnancy rate and implantation rate of group B were significantly higher than the other two groups.The costeffectiveness (the cost of gonadotropin per transferable embryo) were$961.4 in group A,$990.9 in group B and$735.9 in group C. Conclusions:The uFSH and rFSH had the same effectiveness in ovarian stimulation in IVF-ET cycles while rFSH was easier to induce moderate-severe OHSS.When they were used combinely,the clinical pregnancy rate and implantation rate were improved.The cost-effectiveness of the rFSH protocol and the combined protocol was the same.The urinary preparation was the most cost-effective due to the difference of its cost per transferable embryo.更多还原