两种降调节方案和降调前不同预处理方法对体外受精结局的影响.docxVIP

降调节标准：E2 ≤30pg/ml; LH＜3.0iu/l; EM＜5mm; FC≤8mm两种降调节方案及降调前不同预处理方法对体外受精结局的影响作者：王梅梅，郝翠芳，包洪初，单英华，葛丽，曲庆兰，张宁，周朋珍【摘要】? 目的比较短效达必佳两种剂量降调节方案以及两种降调节前不同预处理方法对体外受精结局的影响。方法回顾性分析本中心接受长方案降调节的1094个周期，根据达必佳用量及降调节前预处理方法不同分成如下几组：A组：达必佳半量方案(0.05mg)，962个周期;B组：达必佳微量(1/3)方案(0.03mg)，122 个周期;A1组：自然周期达必佳0.05mg降调节组，A2组：OC+人工黄体后达必佳0.05mg降调节组;B1组：自然周期达必佳0.03mg降调节组，B2组：OC+人工黄体后达必佳0.03mg降调节组。比较组间的促排卵情况及妊娠结局。结果 (1)B组的Gn启动量、Gn用量多于A组(P0.05)，B组的Gn天数、平均获卵数、胚胎冷冻率、种植率少于A组(P0.05)。启动前降调节天数、受精率、2PN受精率、2PN卵裂率、优质胚胎率、可移植胚胎率、临床妊娠率、流产率A组与B组组间差异无统计学意义(P0.05)。(2)Gn用量、IVF平均获卵数、IVF 可移植胚胎率、ICSI受精率、ICSI 2PN受精率、ICSI 2PN卵裂率A1与A2组间差异有统计学意义(P0.05)，启动前降调节天数、Gn启动量、Gn天数、优质胚胎率、胚胎冷冻率、流产率A1与A2组间差异无统计学意义(P0.05)。A1组与A2组的种植率、临床妊娠率组间差异有统计学意义(P0.05)。(3)B1组与B2组的促排卵情况及临床结局组间差异均无统计学意义(P0.05)。结论年龄≤38岁，卵巢储备好的患者，自然周期黄体中期进入降调节，临床妊娠率高。年龄38岁，卵巢储备较差的患者，采用短效达必佳1/3支(0.03mg)降调节，即微量长方案，在不延长降调节时间的前提下，获得较高的临床妊娠率。【关键词】? 曲普瑞林;减量降调节;预处理;长方案;体外受精　[Abstract] Objective To compare two kinds of downregulation protocols with different short-acting triptorelin dosage and diverse pretreatments on the clinical outcomes of IVF.Methods Retrospective analysis was carried on in reproductive medicine of Yantai Yuhuangding Hospital containing 1094 cycles. Groups were divided according to the dosage of triptorelin and diverse pretreatments. Group A: the dosage of triptorelin was 0.05mg with 962 cycles. Group B: the dosage of triptorelin was 0.03mg with 122 cycles.Group A was further divided into two subgroups: groupA1(down-regulation at midluteal phase with 0.05mg triptorelin) and group A2(down-regulation at oral contraceptive phase or replenishing extrogenous progesterone with 0.05mg triptorelin ).Similarly,group B1(down-regulation at midluteal phase with 0.03mg triptorelin) and group B2 (down-regulation at Oral contraceptive phase or replenishing extrogenous progesterone with 0.03mg triptorelin) were determined.The controlled ovarian hyperstimulation and the clinical pregnancy outcome were compared separately.Results (1) The starting dosage and total dosage of Gn