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目的:探讨微刺激促排卵在IVF/ICSI卵巢低反应患者中的应用。方法:回顾性分析进行IVF/ICSI助孕的卵巢低反应患者共114个周期,根据用药情况分为3组:A组(来曲唑组,34个周期),B组(克罗米芬组,41个周期),C组(短方案组,39个周期)。比较3组患者的一般情况、Gn使用天数及总量、IVF相关指标及助孕结局。结果:①年龄、体质量指数(BMI)、不孕年限、基础内分泌水平组间比较均无统计学差异(P>0.05)。②A组Gn使用天数及总量、hCG注射日E2水平、优质胚胎率低于C组(P<0.05);hCG注射日LH水平、提前排卵率高于C组(P<0.05);平均获卵数、受精率、卵裂率、着床率、临床妊娠率A组与C组间比较均无统计学差异(P>0.05)。③B组Gn使用天数及总量、hCG注射日E2水平、平均获卵数、卵裂率均低于C组(P<0.05);hCG注射日LH水平高于C组(P<0.05);提前排卵率、受精率、优质胚胎率、着床率、临床妊娠率B组与C组间均无统计学差异(P>0.05)。④B组Gn使用天数及总量高于A组(P<0.05);其余相关指标组间比较均无统计学差异(P>0.05)。结论:微刺激方案可以获得与GnRH-a短方案相近的临床效果,同时降低Gn使用总量,减轻患者单周期治疗费用,是卵巢储备功能低下患者较理想的促排卵方案。
Objective: To investigate the application of micro-stimulation of ovulation in IVF / ICSI patients with low ovarian response. Methods: A total of 114 cycles of ovarian hyporesponse for IVF / ICSI assisted pregnancy were retrospectively analyzed. The patients were divided into three groups according to their medical conditions: group A (letrozole group, 34 cycles), group B (clomiphene group, 41 Cycles), Group C (short protocol, 39 cycles). The general situation, the days of use of Gn, the total amount of IVF, the index of IVF and the pregnancy outcome were compared among the three groups. Results: ① There was no significant difference in age, body mass index (BMI), duration of infertility, and basic endocrine levels (P> 0.05). (2) The days and total amount of Gn in group A, the level of E2 on the day of hCG injection, the rate of high-quality embryos in group A were lower than those in group C (P <0.05); the level of LH was higher on the day of hCG injection and the rate of early ovulation was higher than that of group C Number, fertilization rate, cleavage rate, implantation rate, clinical pregnancy rate between groups A and C were no significant difference (P> 0.05). (3) The days and total amount of Gn in group B were higher than those in group C on the day of hCG injection (P <0.05); the levels of E2 and the number of oocytes retrieved on hCG injection day were lower than those in group C (P <0.05) Oviposition rate, fertilization rate, high quality embryo rate, implantation rate and clinical pregnancy rate had no significant difference between group B and group C (P> 0.05). (4) The days and total amount of Gn in group B were higher than those in group A (P <0.05). There was no significant difference between the other related groups (P> 0.05). Conclusions: Micro-stimulus can achieve clinical effect similar to short GnRH-a regimen while reducing the total amount of Gn used to reduce the cost of single-cycle treatment in patients with ovarian reserve dysfunction in patients with ovulation is the ideal program of ovulation.