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目的:探讨不同超促排卵方案全部胚胎冷冻后行冻融胚胎移植(FET)的临床妊娠结局。方法:回顾性分析360例患者全胚胎冷冻后复苏移植周期的临床结局。按促排卵方案分为3组,A组:GnRH-a长方案组(n=131),B组:GnRH-a短方案(n=110),C组:CC+hMG组(n=119),按年龄段(<35岁,≥35岁)分别比较3组的促排卵效果及妊娠结局,并且以基础FSH(bFSH)=10 IU/L为界,把C组患者分为bFSH<10 IU/L和bFSH≥10 IU/L 2个亚组,比较其促排卵效果及妊娠结局。结果:C组获卵数、Gn使用总量、Gn用药天数显著低于A和B组(P<0.05),受精率和优质胚胎率高于A和B组(P<0.05);不同年龄段中C组与A和B组的临床妊娠结局均无统计学差异。3组的临床妊娠率分别为42.5%、35.6%、38.9%,胚胎种植率分别为23.9%、21.9%、17.2%,组间无统计学差异(P>0.05)。C组中bFSH≥10 IU/L亚组与bFSH<10 IU/L亚组的促排卵效果及妊娠结局无显著差异(P>0.05)。结论:CC+hMG方案在全部胚胎冷冻后行FET的患者中能取得与GnRH-α长、短方案相似的临床效果,同时Gn的用量大大低于长、短方案组,降低了药物对卵巢过度刺激造成的并发症,减轻了患者的经济和心理负担。
Objective: To investigate the clinical pregnancy outcomes of frozen-thawed embryo transfer (FET) after all embryos were frozen in different superovulation protocols. Methods: The clinical outcome of 360 cycles of frozen-thawed whole-embryo transfer in all patients was retrospectively analyzed. According to the ovulation induction schedule, the patients were divided into three groups: group A: long-term GnRH-a group (n = 131); group B: short GnRH-a (n = 110); group C: , The ovulation effect and pregnancy outcome of the three groups were compared by age group (<35 years old, ≥35 years old), and the patients in group C were divided into bFSH <10 IU / L and bFSH≥10 IU / L 2 subgroups to compare their ovulation induction effect and pregnancy outcome. Results: The number of oocytes in G group, the total amount of Gn used, the days of Gn treatment were significantly lower than those in A and B groups (P <0.05), the rate of fertilization and high quality embryos were higher than those in A and B groups (P <0.05) There was no significant difference in clinical pregnancy outcomes between group C and group A and group B. The clinical pregnancy rates of the three groups were 42.5%, 35.6% and 38.9%, respectively. The embryo implantation rates were 23.9%, 21.9% and 17.2% respectively. There was no significant difference between the two groups (P> 0.05). In group C, there was no significant difference in ovulation induction effect and pregnancy outcome between bFSH≥10 IU / L subgroup and bFSH <10 IU / L subgroup (P> 0.05). Conclusion: The CC + hMG regimen can achieve the same clinical effect as GnRH-α long and short regimen in all patients with FET after cryoablation, and the dosage of Gn is much lower than that of the long and short regimen group, reducing the drug over ovarian To stimulate the complications caused, reducing the patient’s financial and psychological burden.