【摘要】 <正>世界上第一例试管婴儿采用自然周期方案,随后随着控制性超排卵(COH)的应用大大提高了试管婴儿获卵数及妊娠率。近年来生殖专家不再一味追求获卵数,而更关注卵母细胞及胚胎的质量,特别是对于高龄不孕患者。现在多个研究发现体外受精(IVF)的COH过程中卵巢反应不良的发生率在高龄妇女显著增高。中国高龄不孕患者逐年升更多还原

【Abstract】 Objective;To determine which FSH,urinary or recombinant,has better efficacy in elder Chinese women undergoing assisted reproductive techniques（ART）. Methods:A total of 508 patients over 37 years were randomized into two groups,254 cycles for each group.254 patients were treated with recombinant FSH,and another 254 patients with urinary FSH.The patients in both groups were down-regulated by the gonadotrophin-releasing hormone（GnRH） analogue long protocol.The main outcomes including days of stimulation,serum E₂level on the HCG day,number of oocytes collected,total amount of FSH,ratio of FSH/oocyte,MⅡoocyte rate,2PN zygote rate,grade 1 embryo rate,pregnancy rate,implantation rate,miscarriage rate and cycle cancellation rate were compared between the two groups. Results:Twenty two cycles including 16 cycles with poor ovarian response and six cycles with varian hyperstimulation syndrome were cancelled.There were 243 cycles left in each group.The patients treated with urinary FSH had a significantly higher 2PN zygote rate（87.4%vs.76.6%,P<0.001） and grade 1 embryo rate（49.8%vs.40.8%,P<0.001）,and a lower cycle cancellation rate（1.2%vs.5.3%, P = 0.019）than those treated with recombinant FSH.The other parameters evaluated did not show any significant difference between the two groups（P>0.05）.However,lower miscarriage rate（23.5%vs. 29.1%）（although not significant）in urinary FSH group might be noteworthy. Conclusions:Our study showed that urinary FSH performed better in aged Chinese women than recombinant FSH,although both kinds of FSHs produced roughly equivalent pregnancy outcomes.更多还原