卵巢储备功能正常的中重度子宫内膜异位症患者超长方案行IVF促排卵及妊娠结局

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摘要目的探讨卵巢储备功能正常的中、重度子宫内膜异位症(简称内异症)患者应用超长方案行IVF的促排卵及妊娠结局。方法回顾性分析2007年1月—2011年12月中、重度内异症患者应用超长方案行IVF促排卵及妊娠结局(观察组,95个周期)及同期单纯输卵管因素患者应用黄体期长方案行IVF促排卵及妊娠结局(对照组,1 654个周期)。结果观察组Gn总量高于对照组[(44.4±9.9)U,(25.5±7.1)U],获卵数[(10.4±4.8)个]及可利用胚胎数[(3.7±2.3)个]低于对照组[(11.5±4.3)个,(5.3±3.2)个]。观察组Gn启动日[(0.46±0.26)U/L]及hCG日血清LH水平[(0.47±0.26)U/L]低于对照组[(1.01±0.56) U/L,(1.38±4.75)U/L]。两组临床妊娠率、种植率、流产率、分娩率比较,差异均无统计学意义。结论对于卵巢储备功能正常的中、重度内异症患者,应用超长方案促排卵可获得良好的妊娠结局。超长方案对垂体抑制较强,卵巢反应性降低。

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	王俊霞
	侯晓妮
	朱静静
	王玢
	周建军
	邢俊
	孙海翔

关键词 ：子宫内膜异位症, 体外受精-胚胎移植, 卵巢储备功能, 超长方案

Abstract：Objective To examine the outcome of in vitro fertilization (IVF) after long-term pituitary down-regulation for women with moderate or severe endometriosis and normal ovarian reserve. Methods A retrospective analysis was performed on 95 prolonged protocol IVF cycles for women with moderate or severe endometriosis and normal ovarian reserve. A total of 1654 long protocol IVF-ET cycles performed during the same period with tubal infertility and normal ovarian reserve were considered as controls. Results The doses of gonadotropins were significantly higher in the group with endometriosis than in the tubal factor group (44.4±9.9 U vs. 25.5±7.1 U, P<0.05). The number of retrieved oocytes and the number of transferable embryos were significantly lower in the endometriosis group than in the tubal factor group (10.4±4.8 vs. 11.5±4.3, and 3.7±2.3 vs. 5.3±3.2, respectively). The levels of luteinizing hormone on gonadotropins (Gn) launch day and hCG injection day were significantly lower in the endometriosis group than in the tubal factor group (0.46±0.26 U/L vs. 1.01±0.56 U/L, and 0.47±0.26 U/L vs. 1.38±4.75 U/L, respectively). The clinical pregnancy (69.2% vs. 70.2%), implantation (47.6% vs. 51.5%), miscarriage (14.3% vs. 9.7%) and delivery rate (58.2% vs. 61.5%) were comparable between the two groups. Conclusion The outcomes of IVF conducted with prolonged GnRH-a protocol on women with moderate or severe endometriosis were good if the women had normal ovarian reserve. However, ovarian response decreased in the endometriosis group after long-term pituitary down-regulation.

Key words： Endometriosis In vitro fertilization-embryo transfer (IVF-ET) Ovarian reserve Prolonged protocol

收稿日期: 2014-12-15

通讯作者: 孙海翔(stevensunz@163.com)

引用本文:

王俊霞, 侯晓妮, 朱静静, 王玢, 周建军, 邢俊, 孙海翔. 卵巢储备功能正常的中重度子宫内膜异位症患者超长方案行IVF促排卵及妊娠结局[J]. 中国生育健康杂志, 2015, 26(5): 408-411.
WANG Junxia, HOU Xiaoni, ZHU Jingjing, WANG Bin, ZHOU Jianjun, XING Jun, SUN Haixiang. Outcome of in vitro fertilization after long-term pituitary down-regulation for women with moderate or severe endometriosis and normal ovarian reserve. Chinese Journal of Reproductive Health, 2015, 26(5): 408-411.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2015/V26/I5/408

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