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目的:探讨亮丙瑞林在早卵泡期超长方案体外受精/卵细胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)助孕治疗中的垂体降调节效果及临床结局。方法:回顾性分析本中心行早卵泡期超长方案的974例患者的临床资料,其中亮丙瑞林组385例,曲普瑞林组589例,分析患者的降调节效果及临床妊娠结局。结果:垂体降调节30 d后亮丙瑞林组患者的FSH及E_2水平显著高于曲普瑞林组(P<0.01),LH水平无统计学差异(P=0.38);亮丙瑞林组的Gn启动时间明显早于曲普瑞林组(P<0.01),因此超促排卵过程中曲普瑞林组内源性早发LH峰形成率显著高于亮丙瑞林组(P<0.01);患者的临床妊娠率、流产率、周期取消率及中重度卵巢过度刺激综合征(OHSS)发生率组间均无统计学差异(P>0.05),但亮丙瑞林组的胚胎种植率明显高于曲普瑞林组(57.61%vs 52.13%,P=0.046)。结论:垂体降调节作用更温和的亮丙瑞林更符合早卵泡期超长方案对内源性性激素水平抑制的要求;在早卵泡期超长方案中使用亮丙瑞林降调节可获得更佳的临床结局。
Objective: To investigate the hypopituitarism and clinical outcome of leuprorelin in IVF / ICSI-ET assisted pregnancy in the early follicular phase of long-term in vitro fertilization / oocyte cytoplasmic sperm injection-embryo transfer (IVF / ICSI-ET). Methods: The clinical data of 974 patients with long follicular phase overlength in our center were retrospectively analyzed. Among them, 385 patients in the leuprorelin group and 589 patients in the triptorelin group were retrospectively analyzed. The down-regulation effect and clinical pregnancy outcome were analyzed. Results: The level of FSH and E 2 in the patients receiving leuprolide for 30 days was significantly higher than that in the triptorelin group (P <0.01), but not in the levoprillin group (P = 0.38) (P <0.01). The incidence of LH positive peak in triptorelin group was significantly higher than that in leuprorelin group (P <0.01). There was no significant difference in clinical pregnancy rate, miscarriage rate, cycle cancellation rate and incidence of moderate-severe ovarian hyperstimulation syndrome (OHSS) between the two groups (P> 0.05), but the embryo implantation rate in the group of leuprolide was significantly higher In the triptorelin group (57.61% vs 52.13%, P = 0.046). CONCLUSIONS: The more potent hypothyroidism of leuprolide is more in line with the requirement of the long-term follicular-phase regimen for the suppression of endogenous sex hormone levels and the better use of leuprorelin down regulation in the long-term follicle-term regimen The clinical outcome.