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目的:探讨200 IU hCG在控制性卵巢刺激(COS)过程的晚卵泡期替代hMG对COS的疗效。方法:回顾性分析行体外受精/单精子卵胞质内注射-冻融胚胎移植(IVF/ICSI-FET)患者资料共154例,进行154个COS周期,根据晚卵泡期是否应用200 IU hCG分为:A组,COS完全应用hMG(65个周期);B组,COS的早卵泡期应用hMG,晚卵泡期则应用hCG(200 IU/d)替代hMG(89个周期)。后续166个周期进行FET,其中,A组70个周期,B组96个周期。统计分析COS周期的用药情况、IVF/ICSI-FET结局。结果:B组的hMG用药剂量和用药时间分别显著少于A组(1 361.0±494.6 IU vs 1 782.7±475.2 IU,P<0.05;7.3±2.3 d vs 9.5±2.0 d,P<0.05);B组的成熟卵母细胞数显著多于A组(15.2±6.6 vs 11.6±5.7,P<0.05);冻融胚胎移植中A、B组的临床妊娠率(64.29%vs 64.58%,P>0.05)及活产率(80.00%vs 79.03%,P>0.05)比较无统计学差异。结论:200 IU hCG能够在COS的晚卵泡期替代hMG,能安全、有效地维持卵泡生长发育,并且减少Gn的用量,避免卵巢过度刺激综合征(OHSS)发生。
OBJECTIVE: To investigate the therapeutic effect of 200 IU hCG on COS in late-follicular phase of control ovary stimulation (COS). METHODS: A total of 154 patients undergoing IVF / ICSI-FET were retrospectively analyzed for 154 COS cycles. According to whether 200 IU hCG was used in the late follicular phase : Group A, hMG (65 cycles) was fully administered with COS; group B, hMG was administered during early follicular phase of COS, and hCG (200 IU / d) was substituted for hMG during the late follicular phase (89 cycles). FETs were performed in 166 consecutive cycles, with 70 cycles in group A and 96 cycles in group B. Statistic analysis of COS cycle medication, IVF / ICSI-FET outcomes. Results: The dosage of hMG and the time of treatment in group B were significantly less than those in group A (1 361.0 ± 494.6 IU vs 1 782.7 ± 475.2 IU, P <0.05; 7.3 ± 2.3 d vs 9.5 ± 2.0 d, P <0.05) The number of mature oocytes in group A and B was significantly higher than that in group A (15.2 ± 6.6 vs 11.6 ± 5.7, P <0.05). The clinical pregnancy rates in group A and B were 64.29% vs 64.58% (P> 0.05) And live birth rate (80.00% vs 79.03%, P> 0.05) no statistical difference. CONCLUSION: 200 IU hCG can replace hMG in the late stage of COS, maintain the growth of follicles safely and effectively, reduce the dosage of Gn and avoid the occurrence of ovarian hyperstimulation syndrome (OHSS).