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[促性腺激素释放激素激动剂用于黄体支持的辅助生殖技术后妊娠、分娩及婴儿的随访结果分析]

[Analysis of the follow-up results concerning pregnancy, delivery and infants after assisted reproductive technique with GnRH-a for luteal support].

作者信息

Zhou Weiqin, Pan Yanping, Zhuang Yanyan, Xia Fei, Mao Caiping

机构信息

Reproductive Medicine Center, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2016 Jan;51(1):31-5. doi: 10.3760/cma.j.issn.0529-567X.2016.01.008.

Abstract

OBJECTIVE

To investigate the results of follow-up visits of pregnancy course, delivery and infants of women who got clinically pregnant by assisted reproductive technique after gonadotropin-releasing hormone agonist (GnRH-a) added for luteal support, and to analyse the influence of adding GnRH-a in luteal support on the safety of mother and infant.

METHODS

A retrospective analysis was carried out on the medical record from 215 patients who got clinically pregnant after luteal phase long regimen fresh-cycle transfer was operated. According to the differences in luteal support methods, the patients were assigned to Group A (124 patients, progesterone+dydrogesterone group), Group B (91 patients, GnRH-a added group). The patients' pregnancy course, delivery time, and the growth and development of infants within 1-2 years were followed up.

RESULTS

(1) There was no obvious difference between Group A and Group B in terms of the abortion ratio during the early pregnancy (8.1%, 12.1%), the rate of abortion villous deformity (50.0%, 9.1%), the rate of heterotopic pregnancy (10.5%, 5.5%) and rate of twin pregnancy (19.4%, 28.6%; all P>0.05). (2) Compared to group A, during the middle and late pregnancy of single or twin pregnancy in Group B , there was no obvious difference in the rate of fetal chromosomal abnormality, organ malformation incidence, late abortion rate and stillbirth rate (all P>0.05). (3) As to childbirth, in the case of twin pregnancy, there was a higher rate of premature delivery (60.0%, 39.1%; P=0.041), as well as rate of lower birth weight of newborn (56.0%, 34.8%; P=0.037) in group B. (4) The statistics on general growth and development as well as infantile common diseases within 2 years after birth indicated that there was no obvious difference between the two groups in single birth and twin birth subgroup (all P>0.05).

CONCLUSION

On the basis of controlling of implanted embryos and reducing the occurrence of twins, GnRH-a luteal support maybe relatively safe and effective.

摘要

目的

探讨在辅助生殖技术临床妊娠后添加促性腺激素释放激素激动剂(GnRH-a)进行黄体支持的妇女的妊娠过程、分娩及婴儿随访结果,并分析在黄体支持中添加GnRH-a对母婴安全性的影响。

方法

对215例行黄体期长效方案新鲜周期移植后临床妊娠患者的病历进行回顾性分析。根据黄体支持方法的不同,将患者分为A组(124例,黄体酮+地屈孕酮组)、B组(91例,添加GnRH-a组)。对患者的妊娠过程、分娩时间以及婴儿1至2岁内的生长发育情况进行随访。

结果

(1)A组与B组在早期妊娠流产率(8.1%,12.1%)、流产绒毛畸形率(50.0%,9.1%)、异位妊娠率(10.5%,5.5%)和双胎妊娠率(19.4%,28.6%;均P>0.05)方面无明显差异。(2)与A组相比,B组单胎或双胎妊娠的中晚期妊娠胎儿染色体异常率、器官畸形发生率、晚期流产率和死产率无明显差异(均P>0.05)。(3)在分娩方面,双胎妊娠时,B组早产率(60.0%,39.1%;P=0.041)以及新生儿低出生体重率(56.0%,34.8%;P=0.037)较高。(4)出生后2年内的一般生长发育及婴幼儿常见疾病统计表明,单胎和双胎亚组的两组间无明显差异(均P>0.05)。

结论

在控制植入胚胎数量和减少双胎妊娠发生的基础上,GnRH-a黄体支持可能相对安全有效。

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