延长促性腺激素给药对体外受精中意外卵巢反应不良者的影响。
Effects of prolonging administration gonadotropin on unexpectedly poor ovarian responders undergoing in vitro fertilization.
机构信息
Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China.
出版信息
Reprod Biol Endocrinol. 2010 Mar 17;8:26. doi: 10.1186/1477-7827-8-26.
BACKGROUND
There are still some patients who show poor response to ovarian stimulation prior to evidence of normal ovarian reserve in vitro fertilization. However, there are few studies about how to treat the unexpectedly ovarian poor responder in vitro fertilization. The main aim of this study evaluate the effect of prolonging administration follicle-stimulating hormone in woman with the unexpectedly ovarian poor responder in vitro fertilization on implantation rate, clinical pregnancy rate and live birth rate.
METHODS
922 patients subjected to IVF were divided into two groups according to the predicted criterion of ovarian poor response. 116 patients predicted poor response received the short protocol (group C). The others received the long protocol, among the latter, there were 149 patients undergoing unexpectedly ovarian poor response (group B) and 657 patients exhibited normal ovarian response (group A). The doses of gonadotropin, duration of administration, implantation rate, clinical pregnancy rate and live birth rate were recorded among three groups.
RESULTS
The implantation rate of embryo, clinic pregnancy rate and delivery rate are similar between the group A and group B, while there are significant differences between the doses of gonadotropins (35.1 +/- 8.9 ampules vs.53.0 +/- 15.9 ampules) and the duration of administration (15.3 +/- 3.6D vs. 9.8 +/- 2.6D) of these two groups. There are no significant differences about clinical pregnancy rate and live birth rate between group B and group C.
CONCLUSION
Prolonging administration gonadotropin on the unexpectedly poor ovarian responders does not lower live birth rate in vitro fertilization.
背景
仍有一些患者在体外受精中出现正常卵巢储备的情况下对卵巢刺激反应不佳。然而，关于如何治疗体外受精中意外卵巢反应不良者的研究甚少。本研究的主要目的是评估在体外受精中对意外卵巢反应不良者延长促卵泡激素给药时间对胚胎着床率、临床妊娠率和活产率的影响。
方法
根据卵巢反应不良的预测标准，将 922 例接受体外受精的患者分为两组。116 例预测反应不良的患者接受短方案（C 组）。其余患者接受长方案，其中 149 例出现意外卵巢反应不良（B 组），657 例卵巢反应正常（A 组）。记录三组患者的促性腺激素剂量、给药时间、胚胎着床率、临床妊娠率和活产率。
结果
A 组和 B 组的胚胎着床率、临床妊娠率和分娩率相似，而两组的促性腺激素剂量（35.1±8.9 支与 53.0±15.9 支）和给药时间（15.3±3.6D 与 9.8±2.6D）存在显著差异。B 组和 C 组的临床妊娠率和活产率无显著差异。
结论
延长意外卵巢反应不良者的促性腺激素给药时间并不会降低体外受精的活产率。
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