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与促性腺激素释放激素拮抗剂方案相比,孕激素预处理的卵巢刺激对接受体外受精/卵胞浆内单精子注射的卵巢反应不良者是一种可行的方法:一项回顾性研究。

Progestin-primed ovarian stimulation is a feasible method for poor ovarian responders undergoing in IVF/ICSI compared to a GnRH antagonist protocol: A retrospective study.

作者信息

Huang Pinxiu, Tang Minling, Qin Aiping

机构信息

Reproductive Medicine Center, The first affiliated Hospital of Guangxi Medical University, Nanning 530021, China; Reproductive Medicine Center, Liuzhou Maternal and Child Healthcare Hospital, Liuzhou 530021, China.

Reproductive Medicine Center, The first affiliated Hospital of Guangxi Medical University, Nanning 530021, China; Guilin People's Hospital, Guilin 541000, China.

出版信息

J Gynecol Obstet Hum Reprod. 2019 Feb;48(2):99-102. doi: 10.1016/j.jogoh.2018.10.008. Epub 2018 Oct 12.

Abstract

BACKGROUND

Poor ovarian response (POR) to ovarian hyperstimulation is one of the biggest challenges in assisted reproduction technology. The objective of this study was to compare the efficacy of progestin-primed ovarian stimulation (PPOS) with a GnRH antagonist (GnRH-ant) in poor ovarian response (POR) patients.

MATERIALS AND METHODS

This retrospective analysis included a total of 186 cycles of POR patients between 2014 and 2016. The patients were divided into two groups according to the method of stimulation protocol, as follows: 63 cycles were PPOS, and 123 cycles were GnRH-ant. Reproduction-related clinical outcomes in the two groups were compared.

RESULTS

There were no significant differences in patients' age, dose and duration of gonadotropin (Gn) treatment, serum luteinizing hormone (LH) and E2 levels on the day of hCG injection, or the number of oocytes retrieved between the two groups. The MII oocyte rates, fertilization rates, good-quality embryo rates were significantly higher in the PPOS group than they were in the antagonist group (p<0.05). In the subsequent frozen-thawed embryo transfer (FET), clinical pregnancy and live birth rates were significantly higher in the PPOS group than they were in the antagonist group (p<0.05).

CONCLUSIONS

Compared with the GnRH-ant protocol, the PPOS protocol may be a better regime for POR that can effectively improve clinical pregnancy and live birth rates.

摘要

背景

卵巢对超促排卵反应不良(POR)是辅助生殖技术中最大的挑战之一。本研究的目的是比较孕激素预处理卵巢刺激(PPOS)与促性腺激素释放激素拮抗剂(GnRH-ant)方案在卵巢反应不良(POR)患者中的疗效。

材料与方法

本回顾性分析纳入了2014年至2016年间共186个周期的POR患者。根据刺激方案的方法将患者分为两组,如下:63个周期采用PPOS方案,123个周期采用GnRH-ant方案。比较两组与生殖相关的临床结局。

结果

两组患者的年龄、促性腺激素(Gn)治疗的剂量和持续时间、注射hCG当天的血清黄体生成素(LH)和雌二醇(E2)水平,或获取的卵母细胞数量均无显著差异。PPOS组的MII卵母细胞率、受精率、优质胚胎率均显著高于拮抗剂组(p<0.05)。在随后的冻融胚胎移植(FET)中,PPOS组的临床妊娠率和活产率显著高于拮抗剂组(p<0.05)。

结论

与GnRH-ant方案相比,PPOS方案可能是一种更适合POR患者的方案,可有效提高临床妊娠率和活产率。

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