【摘要】 目的比较分析体外受精-胚胎移植(IVF-ET)周期应用促性腺激素释放激素(GnRH-ant)拮抗剂方案中用或未用口服避孕药(达英-35)预处理患者的临床特征和治疗结局。方法回顾性分析252个IVF-ET移植周期,分为3组,A组:116例,达英-35预处理GnRH-ant方案移植周期组;B组:46例,未用达英-35预处理GnRH-ant方案移植周期组;C组:90例,GnRH-a长方案移植周期组。比较各组患者的年龄、促性腺激素(Gn)使用天数和剂量、HCG日LH水平、取卵日内膜厚度、可用胚胎率、临床妊娠率等。结果 A组平均年龄(30.9±0.8)较B组(33.9±1.7)年轻,有显著性差异(P<0.05);A组Gn使用天数和用量比B组多,但无显著性差异(P>0.05);A组HCG日LH水平和取卵日内膜厚度均较B组显著减少(P<0.05);A组与B组的可用胚胎率无显著性差异(P>0.05);A组临床妊娠率(18.1%)较B组(37.0%)显著下降(P<0.05);B组临床妊娠率(37.0%)与C组(38.8%)相比较无显著性差异(P>0.05)。结论在IVF-ET治疗中应用口服避孕药预处理GnRH-ant方案,妊娠率显著下降,但未用口服避孕药预处理的GnRH-ant方案,能获得满意的临床结局。更多还原

【Abstract】 Objective:To analyze the clinical features and outcome of patients who used or did not used oral contraceptive(Diane-35)pretreatment before gonadotropin releasing hormone antagonist(GnRH-ant)protocol during in vitro fertilization-embryo transfer(IVF-ET)cycles.Methods:All the IVF-ET cycles were divided to three groups.The patients in group A(n=116)used oral contraceptive before GnRH-ant treatment.The patients in group B(n=46)did not used oral contraceptive before GnRH-ant treatment.The patients in group C(n=90)were applied with GnRH agonist(GnRH-a)long protocol cycle.Patient’s age,dose and duration of gonadotropin treatment,serum LH levels on HCG day,endometrial thickness,clinical pregnancy rate etc.were compared among the three groups.Results:The patients’ age in group A were significantly younger than group B(30.9±0.8vs.33.9±1.7)(P<0.05).The dose and duration of gonadotropins(Gn)used in group A were higher than those in group B(P>0.05).The serum LH and the endometrial thickness in group A were significantly lower than those in group B(P<0.05).There were no significant differences in good quality embryos rates among the three groups.The clinical pregnancy rate in group A significantly decreased compared with group B(18.0% vs.37.0%)(P<0.05).There was no significant difference in clinical pregnancy rates between group B and group C(37.0% vs.38.8%).However the dose and duration of Gn in Group B were significantly less than those in group C.Conclusions:Usage of oral contraceptive before GnRH-ant protocol significantly decreases pregnancy rate.However,GnRH-ant protocol without oral contraceptive pretreatment can get a comparable clinical outcome with GnRH-a long protocol.更多还原