体外受精-胚胎移植周期中GnRH拮抗剂和激动剂应用效果的比较

来源 :中华医学会第七次全国生殖医学学术会议 | 被引量 : 0次 | 上传用户:cheney0105
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目的 比较体外受精-胚胎移植(IVF-ET)周期中GnRH拮抗剂与激动剂应用效果.方法 回顾性分析2006年11月~ 2007年6月在本中心接受IVF-ET助孕治疗的330例患者,其中采用GnRH拮抗剂方案的216例;采用GnRH激动剂长方案的114例患者,观察两组用药的临床效果.结果 两组Gn用量、HCG日内膜厚度、受精率、卵裂率之间比较无显著性差异;拮抗剂组种植率、妊娠率、活产率较激动剂组略高(29.47 vs 24.74,54.63 vs 49.12,46.29 vs 41.23),但没有显著差异;拮抗剂组的用药时间明显短于激动剂组(3.58±1.20 vs 23.48±2.72,P<0.01);Gn的应用时间拮抗剂组明显短于拮抗激动剂组(8.95±1.73 vs9.37±1.57,P<0.05),有显著性差异;拮抗剂组的获卵数少于激动剂组(11.04 ±6.16 vs12.74 ±6.99,P<0.05,)有显著性差异.hCG日拮抗剂组的E2水平明显低于激动剂组(1837.06±1009.8vs 2474.47±1506.78,P<0.01),)有显著性差异,而拮抗剂组LH水平高于激动剂组(2.21 ±1.65 vs 1.397±0.63,P<0.01),有显著性差异;拮抗剂组无中重度OHSS的发生.结论 在IVF周期中,应用GnRH拮抗剂方案可以取得与激动剂标准长方案相同的妊娠率,且可缩短用药时间,减少卵巢的刺激,降低OHSS的发生率,同时减少患者费用.
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