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目的探讨使用不同类型的GnRH-a行长方案降调节促排卵治疗,观察其临床疗效,以期选择最合适降调节方案。方法回顾性分析在郑大二附院行IVF助孕的139个周期,根据黄体中期使用不同剂型、剂量的GnRHa降调节进行分组:A组79例每日注射0.1mg GnRH-a(达必佳)3~7d,改为每天注射0.05mg,至HCG注射日。B组29例每日注射0.05mg GnRH-a(达必佳),至HCG注射日。C组于单次注射长效GnRH-a1.23/1.3mg(达必佳),至HCG注射日。结果分析三组数据,降调后的E2水平,B组明显高于C组(P<0.05)。HCG注射日LH的水平,C组明显低于A组(P<0.05)。HCG注射日E2的水平,C组明显高于A组(P<0.05)。在Gn使用量及时间上,C组明显多于A、B组(P<0.05)。在卵裂率上,C组显著低于A、B组(P<0.05)。3组在获卵数、临床妊娠率及流产率无显著差异(P>0.05)。结论此研究中使用短效GnRH-a的优势:与该剂量的长效组比较可以明显减少Gn注射剂量及注射时间,减轻患者经济压力,可以优先选择短效GnRH-a进行降调节促排卵。
Objective To investigate the use of different types of GnRH-a regulators to reduce ovulation induction therapy and observe its clinical efficacy in order to select the most appropriate regimen. Methods A retrospective analysis of 139 cycles of IVF assisted pregnancies in the Affiliated Hospital of Zhengzhou University was performed and divided into groups according to the dosage of GnRHa down regulation in the mid luteal phase: 79 patients in group A received daily 0.1 mg GnRH-a ) 3 ~ 7d, to inject 0.05mg daily, to HCG injection day. In group B, 29 patients were injected with 0.05 mg GnRH-a daily until daidzein injection. Group C in a single injection of long-acting GnRH-a1.23 / 1.3mg (up to good), to HCG injection date. Results The data of three groups were analyzed. The level of E2 after down-regulation was significantly higher in group B than in group C (P <0.05). The level of LH on HCG injection day was significantly lower in group C than in group A (P <0.05). The level of E2 on HCG injection day was significantly higher in group C than in group A (P <0.05). In Gn usage and time, C group was significantly more than A, B group (P <0.05). Cleavage rate, C group was significantly lower than A, B group (P <0.05). There were no significant differences in the number of oocytes retrieved, clinical pregnancy rate and miscarriage rate between the three groups (P> 0.05). Conclusions The short-acting GnRH-a advantage of this study: compared with the dose of long-acting group can significantly reduce the dose of Gn injection and injection time, reduce the economic pressure on patients, you can give priority to short-acting GnRH-a to regulate ovulation.