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目的:比较两种修正的达必佳长方案在体外受精-胚胎移植(IVF-ET)和卵母细胞单精子显微注射(ICSI)中的作用。方法:将行IVF-ET和ICSI的512个治疗周期按其停用达必佳的时间分为两组,比较其在诱发排卵中的效果:A组(早停组):上次月经第21天开始隔日一次皮下注射达必佳0.1mg至Gn第4天;B组(改良组):上次月经第21天开始隔日一次皮下注射达必佳0.1mg至注射HCG日。结果:两组Gn天数、ET评分、生化妊娠率、临床妊娠率、早期流产率、OHSS发生率、LH峰发生率比较无显著性差异(P>0.05);A组达必佳支数明显少于B组(P<0.01),且受精率、卵裂率、M2卵母细胞率高于B组(P<0.01)。结论:Gn第4天停用达必佳即可有效抑制内源性LH峰,且能减少达必佳用量,获得与改良长方案相同的临床效果。
OBJECTIVE: To compare the effects of two modified versions of dasabe long regimen in in vitro fertilization-embryo transfer (IVF-ET) and in oocyte single-sperm microinjection (ICSI). Methods: 512 treatment cycles of IVF-ET and ICSI were divided into two groups according to the time they were to be stopped, and the effect on ovulation induction was compared: group A (early-stop group): the last menstrual period 21 Days after the beginning of the next day subcutaneous injection of daigang 0.1mg to Gn on the 4th day; Group B (modified group): the first menstrual start on the 21st day every other day subcutaneous injection of daubicin 0.1mg to the day of HCG injection. Results: There was no significant difference in Gn days, ET score, biochemical pregnancy rate, clinical pregnancy rate, early miscarriage rate, incidence of OHSS and incidence of LH peak in both groups (P> 0.05). In group B (P <0.01), the fertilization rate, cleavage rate and M2 oocyte rate were higher than those in group B (P <0.01). CONCLUSION: The administration of daubicin on day 4 of Gn can effectively inhibit the endogenous LH peak, and can reduce the dosage of dabigatran to achieve the same clinical effect as the modified long-term regimen.