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长效促性腺激素释放激素激动剂联合经阴道超声引导下囊肿抽吸与单独使用长效促性腺激素释放激素激动剂对体外受精-胚胎移植妊娠结局的比较研究。

Comparative study on the pregnancy outcomes of in vitro fertilization-embryo transfer between long-acting gonadotropin-releasing hormone agonist combined with transvaginal ultrasound-guided cyst aspiration and long-acting gonadotropin-releasing hormone agonist alone.

机构信息

Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

出版信息

Contemp Clin Trials. 2012 Nov;33(6):1206-10. doi: 10.1016/j.cct.2012.07.009. Epub 2012 Jul 20.

DOI:10.1016/j.cct.2012.07.009
PMID:22820320
Abstract

OBJECTIVE

To retrospectively analyze the effects of long-acting gonadotropin-releasing hormone agonist (GnRH-a) combined with transvaginal ultrasound-guided cyst aspiration on the pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) in the infertile patients with ovarian endometriosis.

METHODS

The 134 patients with ovarian endometriosis who underwent GnRH-a combined with transvaginal ultrasound-guided cyst aspiration and IVF-ET were served as experimental group. The 102 patients with ovarian endometriosis who underwent GnRH-a and IVF-ET were served as control group. After treatment, the cyst size, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), number of ovum pick-up, fertility rate, cleavage rate, high-quality embryo rate, implantation rate, clinical pregnancy rate and abortion rate were compared between the two groups.

RESULTS

In the 134 patients of experimental group, 138 cysts disappeared after GnRH-a combined with three times of transvaginal ultrasound-guided cyst aspiration. In the 102 patients of control group, of the 114 cysts, 34 disappeared after GnRH-a, 67 were decreased and 13 were unchanged. The abortion rate was significantly lower in experimental group than in control group. The level of serum E2 on HCG day, the number of ovarian follicles with 14 mm or more, the number of retrieved oocytes, high-quality embryo rate, implantation rate and clinical pregnancy rate were higher in experimental group than in control group (all P<0.05).

CONCLUSION

GnRH-a combined with transvaginal ultrasound-guided cyst aspiration can obtain better therapeutic effects and pregnancy outcomes in infertile patients with ovarian endometriosis who underwent IVF-ET.

摘要

目的

回顾性分析长效促性腺激素释放激素激动剂(GnRH-a)联合经阴道超声引导下囊肿抽吸对卵巢子宫内膜异位症不孕患者体外受精-胚胎移植(IVF-ET)妊娠结局的影响。

方法

将 134 例行 GnRH-a 联合经阴道超声引导下囊肿抽吸与 IVF-ET 的卵巢子宫内膜异位症患者设为实验组,将 102 例行 GnRH-a 与 IVF-ET 的卵巢子宫内膜异位症患者设为对照组。治疗后,比较两组患者的囊肿大小、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、取卵数、妊娠率、卵裂率、优质胚胎率、着床率、临床妊娠率和流产率。

结果

实验组 134 例患者中,经 GnRH-a 联合 3 次经阴道超声引导下囊肿抽吸后,138 个囊肿消失;对照组 102 例患者中,经 GnRH-a 治疗后,114 个囊肿中 34 个消失,67 个缩小,13 个不变。实验组流产率明显低于对照组。实验组患者血清 E2 水平于 HCG 日、直径≥14mm 的卵巢卵泡数、获卵数、优质胚胎率、着床率和临床妊娠率均高于对照组(均 P<0.05)。

结论

对于行 IVF-ET 的卵巢子宫内膜异位症不孕患者,GnRH-a 联合经阴道超声引导下囊肿抽吸可获得更好的治疗效果和妊娠结局。

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