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目的探讨体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)或单精子卵胞浆内注射(Intracytoplasmic sperm injection,ICSI)超排卵长方案中1.25 mg长效曲普瑞林与0.05 mg短效曲普瑞林对垂体的降调节效果。方法回顾分析2009年9月至2010年6月黄体中期长方案降调节252个IVF周期,分为2组,长效药治疗组(A组)123例,长效曲普瑞林1.25 mg降调;短效药治疗组(B组)129例,短效曲普瑞林0.05 mg降调至人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)日。结果降调后促性腺激素(gonadotropin,Gn)日A组促卵泡激素(follicle stimulating hormone,FSH)、血清雌二醇(estradiol,E2)明显低于B组,两组比较,差异有统计学意义(P<0.05);A组促黄体生成素(luteinizing hormone,LH)略高于B组,差异无统计学意义(P>0.05)。HCG日两组LH、P、E2差异无统计学意义(P>0.05)。A组获卵数、胚胎数较B组有明显增高趋势,差异有统计学意义(P<0.05)。A组卵巢过度刺激综合征(ovarianhyperstimulation syndrome,OHSS)发生率高于B组,但差异无统计学意义(P>0.05)。结论 IVF-ET或ICSI超排卵长方案中1.25 mg长效曲普瑞林对垂体的抑制作用更强,能获得更多卵母细胞及胚胎数,且不增加OHSS的发生率。
Objective To investigate the effects of long-acting triptorelin (1.25 mg) in in vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) Short-acting triptorelin on the regulation of hypophysectomy effect. Methods A total of 252 IVF cycles of mid-luteal long-term regimen from September 2009 to June 2010 were retrospectively analyzed. They were divided into two groups: 123 in the long-acting drug treatment group (A group), 1.25 mg in the long-acting triptorelin ; Short-acting drug treatment group (B group) 129 cases, short-acting triptorelin 0.05 mg down to human chorionic gonadotropin (human chorionic gonadotrophin, HCG) day. Results The levels of follicle stimulating hormone (FSH) and estradiol (E2) in gonadotropin group were significantly lower than those in group B after gonadotropin (Gn) lowering, the difference was statistically significant (P <0.05). Luteinizing hormone (LH) in group A was slightly higher than that in group B, with no significant difference (P> 0.05). There was no significant difference in LH, P and E2 between the two groups on HCG day (P> 0.05). The number of oocytes and embryos in group A was significantly higher than that in group B, the difference was statistically significant (P <0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) in group A was higher than that in group B, but the difference was not statistically significant (P> 0.05). Conclusions 1.25 mg long-acting triptorelin is more potent to pituitary in IVF-ET or ICSI long-term regimen, and more oocytes and embryos can be obtained without increasing the incidence of OHSS.