【摘要】 目的探讨醋酸曲普瑞林长方案降调节前预处理对多囊卵巢综合征(PCOS)患者行体外受精-胚胎移植(IVF-ET)术效果的影响。方法纳入行IVF-ET的197例PCOS患者,根据降调节前是否预处理分为A组(n=103)和B组(n=94)。所有患者于月经来潮第2天给予3. 75 mg醋酸曲普瑞林,B组于降调节前一个月经周期的第3天口服去氧孕烯炔雌醇片预处理,A组不做任何预处理。比较两组患者治疗前及开始使用促性腺激素(Gn)时的激素水平、卵巢过度刺激综合征(OHSS)发生率、Gn使用量及时间、获得卵细胞及优质胚胎数、妊娠结局。结果两组患者开始使用Gn时促卵泡激素及黄体生成素水平低于术前,雌二醇高于术前(均P <0. 05),但两组患者各阶段激素水平比较差异均无统计学意义(均P> 0. 05)。两组患者OHSS发生率差异无统计学意义(P>0. 05),而A组患者Gn使用总量及持续使用时间均少于或短于B组(均P <0. 05)。A组患者获得卵细胞数和优质胚胎数均多于B组(均P <0. 05),但两组患者受精率、胚胎种植率、减胎率及流产率差异均无统计学意义(均P>0.05)。结论对于行IVF-ET的PCOS患者,在醋酸曲普瑞长方案降调节前应避免行预处理,以减少促排卵的时间及用药量,并增加获得卵细胞及优质胚胎的数量。更多还原

【Abstract】 Objective To investigate the effect of preconditioning prior to long protocol with triptorelin acetate for down-regulation on efficacy of in vitro fertilization-embryo transfer( IVF-ET) in patients with polycystic ovary syndrome( PCOS). Methods A total of 197 PCOS patients undergoing IVF-ET were enrolled and divided into group A( n = 103) and group B( n = 94) according to the presence of preconditioning prior to down-regulation. All patients were given 3. 75 mg of triptorelin acetate on the second day of menses,group B received preconditioning with oral Desogestrel and Ethinylestradiol Tablets on the third day of the last menstrual cycle prior to down-regulation,and group A did not received any pretreatment. The two groups were compared in items of hormone levels before treatment and at the time of initiating gonadotropin( Gn) treatment,incidence rate of ovarian hyperstimulation syndrome( OHSS),dosage and duration of Gn use,number of oocytes arrested or high-quality embryos,and pregnancy outcome. Results At the time of initiating Gn treatment,patients in the two groups obtained lower levels of folliclestimulating hormone and luteinizing hormone and a higher estradiol level as compared with the preoperation( all P < 0. 05),but there was no statistically significant difference between the two groups in hormone levels at any phase( all P >0. 05). No statistically significant difference was found in incidence rate of OHSS between the two groups( P >0. 05),while group A possessed less total dosage of Gn use and shorter duration of Gn use than group B( all P < 0. 05). Group A obtained more oocytes arrested and high-quality embryos in comparison with group B( all P < 0. 05),however,there was no statistically significant difference between the two groups in fertilization rate,embryo implantation rate,reduction rate or abortion rate( all P > 0. 05). Conclusion Patients with PCOS undergoing IVF-ET should keep from performing preconditioning prior to long protocol with triptorelin acetate for down-regulation,thus reducing ovulation duration and dosage of medication as well as increasing number of oocytes arrested and high-quality embryos.更多还原