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    • GnRH-a短方案与PPOS方案在高龄卵巢储备功能减退不孕症治疗中的应用对比观察

    焦婷婷,李建华,张水文,魏岩,成彦彬,王建业

    Shandong Medical Journal（2022）

    Cited 0|Views21
    Abstract
    目的 比较高龄卵巢储备功能减退不孕症患者使用促性腺激素释放激素类似物(GnRH-a)短方案和高孕激素状态下促排卵方案(PPOS)的妊娠结局和临床效果.方法 收集进行体外受精/卵胞质内单精子注射—胚胎移植(IVF/ICSI-ET)的高龄卵巢储备功能减退不孕症患者临床资料,根据促排卵方案不同分为短方案组(采取GnRH-a短方案,共124个周期)和PPOS组(采取PPOS方案,共95个周期),比较两组卵巢功能基本情况,包括基础窦卵数、基础卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2);促排卵周期取消情况,包括促排卵周期总取消率、早发排卵周期率、未取到卵周期率、异常或未受精周期率、无可移植胚胎周期率;用药和排卵情况,包括Gn用药天数和总剂量、获卵数、受精率、卵裂率、优质胚胎数;妊娠结局情况,包括胚胎种植率、生化妊娠率、临床妊娠率、活产率、累积分娩率.结果 两组基础窦卵泡数和基础FSH、LH、E2比较差异均无统计学意义(P均>0.05).短方案组因早发排卵导致的取卵周期取消率高于PPOS组(P<0.05).两组Gn天数、Gn总剂量、获卵数、受精率、卵裂率、优质胚胎数比较差异均无统计学意义(P均>0.05).两组种植率、生化妊娠率、临床妊娠率和活产率比较差异均无统计学意义(P均>0.05),短方案组的累积分娩率高于PPOS组(P<0.05).结论 GnRH-a短方案和PPOS方案都可作为高龄卵巢储备功能减退不孕症患者行辅助生殖技术时促排卵方案的选择,短方案累积分娩率更高,PPOS方案因早发排卵导致的取卵周期取消率更低.
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    【要点】：本研究比较高龄卵巢储备功能减退不孕症患者采用GnRH-a短方案与PPOS方案的妊娠结局和临床效果，发现短方案累积分娩率更高，而PPOS方案早发排卵导致的取卵周期取消率更低。
    

    【方法】：通过收集并分析采用IVF/ICSI-ET治疗的高龄卵巢储备功能减退不孕症患者的临床资料，将患者分为采用GnRH-a短方案的短方案组与采用PPOS方案的PPOS组，对比两组的卵巢功能、促排卵周期取消情况、用药和排卵情况以及妊娠结局。
    

    【实验】：实验涉及124个短方案周期和95个PPOS方案周期，使用的数据集为患者临床资料。结果显示，两组在基础窦卵泡数、基础FSH、LH、E2、Gn天数、Gn总剂量、获卵数、受精率、卵裂率、优质胚胎数、种植率、生化妊娠率、临床妊娠率和活产率等方面差异均无统计学意义，但短方案组的累积分娩率高于PPOS组，而PPOS组因早发排卵导致的取卵周期取消率低于短方案组。