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目的:探究不同时机注射人绒毛膜促性腺激素(hCG)行短效长方案卵胞质内单精子注射(ICSI)助孕术患者的临床结局影响。方法:回顾性分析行ICSI助孕术的200例患者,按传统标准的hCG注射日时间(有3个卵泡平均直径≥17 mm)比较推迟2 d(+2组,n=167)、推迟3 d(+3组,n=31)和推迟4 d(+4组,n=2)ICSI助孕过程中的临床参数及妊娠结局。结果:+3组与+2d组比较,平均直径≥20 mm的卵泡数有上升趋势(6.1±2.4 vs 5.4±2.3);hCG注射日最大卵泡的平均直径达到25.0±2.6 mm,两者有统计学差异(P<0.05);≥20 mm/≥14 mm比值组间差异更大(0.52±0.16 vs 0.46±0.13,P<0.05),P×1 000/E2有降低趋势(0.23±0.12 vs 0.42±1.44),E2/≥14 mm的卵泡数比值有上升趋势(276.73±93.55 vs 246.23±77.03)。卵子回收率、MII卵率、受精率、优质胚胎率、周期取消率、着床率、临床妊娠率、自然流产率、宫外孕率及OHSS发生率均无统计学差异(P>0.05)。结论:对短效长方案患者适度推迟注射hCG时间是值得推行的。
OBJECTIVE: To investigate the clinical outcomes of intracytoplasmic sperm injection (ICSI) with short-acting long-term injection of human chorionic gonadotropin (hCG) at different time points. Methods: A retrospective analysis of 200 patients undergoing ICSI assisted pregnancy was delayed by 2 days (n = 167 in group 2) and delayed by 3 h on the day of standard hCG injection (with an average of 3 follicles ≥ 17 mm) Clinical parameters and pregnancy outcomes during ICSI assisted pregnancy with d (+3, n = 31) and postponed 4 d (+4, n = 2) ICSI. Results: Compared with group + 2d, the average number of follicles with average diameter≥20 mm had an upward trend (6.1 ± 2.4 vs 5.4 ± 2.3). The average diameter of the largest follicle on the day of hCG injection reached 25.0 ± 2.6 mm (P <0.05). The difference between the groups of ≥20 mm / ≥14 mm was more significant (0.52 ± 0.16 vs 0.46 ± 0.13, P <0.05), P × 1000 / E2 decreased (0.23 ± 0.12 vs 0.42 ± 1.44). The ratio of follicles with E2 / ≥14 mm had an increasing trend (276.73 ± 93.55 vs 246.23 ± 77.03). No significant difference was found in egg recovery rate, MII egg rate, fertilization rate, good embryo rate, cycle cancellation rate, implantation rate, clinical pregnancy rate, spontaneous abortion rate, ectopic pregnancy rate and OHSS incidence (P> 0.05). Conclusion: Moderate postponement of hCG injection in short-acting long-term regimen is worthwhile.