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在卵泡晚期联合使用促卵泡生成素(FSH)和低剂量重组人绒毛膜促性腺激素(hCG)与传统控制性卵巢刺激用于卵胞浆内单精子注射周期的比较。

Concomitant use of FSH and low-dose recombinant hCG during the late follicular phase versus conventional controlled ovarian stimulation for intracytoplasmic sperm injection cycles.

作者信息

Iaconelli Carla Andrade Rebello, Setti Amanda Souza, Braga Daniela Paes Almeida Ferreira, Maldonado Luiz Guilherme Louzada, Iaconelli Assumpto, Borges Edson, Aoki Tsutomu

机构信息

a Fertility Medical Group, clinical department ; Sao Paulo , SP , Brazil.

b Faculdade de Ciências Médicas da Santa Casa de São Paulo, health sciences department ; Sao Paulo , SP , Brazil.

出版信息

Hum Fertil (Camb). 2017 Dec;20(4):285-292. doi: 10.1080/14647273.2017.1303197. Epub 2017 Mar 22.

Abstract

The objective of this study was to investigate the effects of low-dose hCG supplementation on ICSI outcomes and controlled ovarian stimulation (COS) cost. Three hundred and thirty patients undergoing ICSI were split into groups according to the COS protocol: (i) control group (n = 178), including patients undergoing conventional COS treatment; and (ii) low-dose hCG group (n = 152), including patients undergoing COS with low-dose hCG supplementation. Lower mean total doses of FSH administered and higher mean oestradiol level and mature oocyte rates were observed in the low-dose hCG group. A significantly higher fertilization rate, high-quality embryo rate and blastocyst formation rate were observed in the low-dose hCG group as compared to the control group. The miscarriage rate was significantly higher in the control group compared to the low-dose hCG group. A significantly lower incidence of OHSS was observed in the low-dose hCG group. There was also a significantly lower gonadotropin cost in the low-dose hCG group as compared to the control group ($1235.0 ± 239.0×$1763.0 ± 405.3, p < 0.001). The concomitant use of low-dose hCG and FSH results in a lower abortion rate and increased number of mature oocytes retrieved, as well as improved oocyte quality, embryo quality and blastocyst formation and reduced FSH requirements.

摘要

本研究的目的是探讨低剂量人绒毛膜促性腺激素(hCG)补充对卵胞浆内单精子注射(ICSI)结局及控制性卵巢刺激(COS)成本的影响。330例接受ICSI的患者根据COS方案分为两组:(i)对照组(n = 178),包括接受传统COS治疗的患者;(ii)低剂量hCG组(n = 152),包括接受低剂量hCG补充的COS患者。低剂量hCG组观察到促卵泡生成素(FSH)平均总给药剂量较低,平均雌二醇水平和成熟卵母细胞率较高。与对照组相比,低剂量hCG组的受精率、优质胚胎率和囊胚形成率显著更高。对照组的流产率显著高于低剂量hCG组。低剂量hCG组卵巢过度刺激综合征(OHSS)的发生率显著更低。与对照组相比,低剂量hCG组的促性腺激素成本也显著更低(1235.0±239.0美元对1763.0±405.3美元,p<0.001)。低剂量hCG与FSH联合使用可降低流产率,增加回收的成熟卵母细胞数量,提高卵母细胞质量、胚胎质量和囊胚形成,并减少对FSH的需求。

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