【摘 要】
：
目的 分析长效低剂量与短效GnRH-a长方案在IVF-ET周期的参数,探讨不同剂量和剂型GnRH-a长方案的安全性和有效性.方法 回顾性分析2011年7月至2012年11月在中山大学附属第一医院生殖医学中心进行IVF-ET治疗的3313例月经正常妇女的(3457个周期)资料,其中长效GnRH-a低剂量长方案3051个周期,短效长方案406个周期.结果 1)血清LH水平:Gn启动日短效方案显著低于长
【机 构】
：
中山大学附属第一医院生殖中心 510080
【出 处】
：
中华医学会第七次全国生殖医学学术会议
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目的 分析长效低剂量与短效GnRH-a长方案在IVF-ET周期的参数,探讨不同剂量和剂型GnRH-a长方案的安全性和有效性.方法 回顾性分析2011年7月至2012年11月在中山大学附属第一医院生殖医学中心进行IVF-ET治疗的3313例月经正常妇女的(3457个周期)资料,其中长效GnRH-a低剂量长方案3051个周期,短效长方案406个周期.结果 1)血清LH水平:Gn启动日短效方案显著低于长效低剂量方案,分别为1.0±0.8 IU/L和1.3±0.8 IU/L, 1.2 ±0.4 IU/L,P＜0.01; HCG日0.375mg组(1.4±1.2 IU/L)显著高于1.3～1.8mg (0.6 ±0.4 IU/L)及0.8-1.0mg (0.7±0.6 IU/L)两组,P值＜0.01.2)卵巢类固醇激素合成:HCG日血清E2水平0.375mg+短效组(3360.8±1426.2 pg/ml)显著高于0.8-1.0mg组(3118.5±1384.1 pg/ml),其余各组之间无差异;HCG日血清P水平短效组显著低于0.375mg+短效,0.8-1.0mg两组(P＜0.01).3)FSH启动剂量短效组、0.375 mg组及0.375+短效组显著高于0.8-1.0mg组,P＜0.01;Gn总量与时间短效组显著低于长效低剂量组,P＜0.01;4)卵巢反应性:获卵数短效组(12.7±7.4个)显著少于长效组,P＜0.01;卵巢高反应发生率在0.8～1.0mg组(26.4％)和1.3 ～ 1.8mg组(28.6％)组高于0.375mg(16％)、0.375+短效组(17.2％)及短效组(17.8％),低反应率在0.8 ～ 1.0mg组及1.3 ～1.8mg组显著低于其它三组,P＜0.05.5)IVF-ET参数:0.8～1.0m组的MⅡ卵子率显著高于其它四组,但卵子利用率、受精率、卵裂率及可用胚胎率均无差异;五组间的临床妊娠率无统计学差异;长效0.8 ～1.0m组种植率(29.5％)显著高于0.375mg+短效组(25％).结论 血清LH水平与GnRH-a剂型和剂量有关,随剂量降低长效GnRH-a也呈现对垂体的不完全抑制作用,在卵巢水平对E2合成没有显著影响.
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