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单独使用生长激素作为辅助治疗对高龄且体重指数(BMI)≥24kg/m²、因胚胎质量差导致体外受精失败患者的益处。

The Advantage of Growth Hormone Alone as an Adjuvant Therapy in Advanced Age and BMI ≥ 24 kg/m with In Vitro Fertilization Failure Due to Poor Embryo Quality.

作者信息

Jiang Shuyi, Fu Lingjie, Zhang Wei, Zuo Na, Guan Wenzheng, Sun Hao, Wang Xiuxia

机构信息

Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 36 SanHao Street, Shenyang 110004, China.

Department of Clinical Epidemiology and Evidence-Based Medicine, the First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, China.

出版信息

J Clin Med. 2023 Jan 26;12(3):955. doi: 10.3390/jcm12030955.

Abstract

This study aimed to assess the effects of GH adjuvant therapy on the cumulative live birth rate in patients with poor embryo quality and to determine the characteristics of patients who are more responsive to GH. A retrospective cohort study was carried out in patients who have suffered from previous IVF failure due to poor embryonic development and underwent IVF with or without a 6-week pretreatment with GH in the subsequent cycle from January 2018 to December 2020. Clinical parameters including the cumulative live birth rate between the (-) GH and (+) GH groups were compared. Multivariate analysis was performed to ascertain associations between clinical parameters and cumulative live birth rate. Upon analysis of the clinical data from 236 IVF cycles, 84 patients received GH and 152 did not receive GH. In frozen embryo transfer cycles, compared with the (-) GH group, the implantation rate and live birth rate were significantly higher in the (+) GH group ( < 0.05). After adjusting for possible confounding factors, GH improved cumulative live birth per oocyte retrieval cycle by 1.96 folds ( = 0.032). Furthermore, when patients were subdivided based on age and BMI, a significant increase in the cumulative live birth rate was found in the (+) GH group of patients between 35 and 42 years old and BMI ≥ 24 kg/m, respectively ( < 0.05). GH may increase the live birth rate in women who experienced IVF failure because of poor embryonic development, particularly in obese patients and women with advanced age.

摘要

本研究旨在评估生长激素(GH)辅助治疗对胚胎质量差的患者累积活产率的影响,并确定对GH反应更敏感的患者特征。对2018年1月至2020年12月期间因胚胎发育不良而先前体外受精(IVF)失败,随后周期接受或未接受为期6周GH预处理进行IVF的患者开展了一项回顾性队列研究。比较了包括(-)GH组和(+)GH组之间累积活产率在内的临床参数。进行多因素分析以确定临床参数与累积活产率之间的关联。在分析236个IVF周期的临床数据时,84例患者接受了GH,152例未接受GH。在冻融胚胎移植周期中,与(-)GH组相比,(+)GH组的着床率和活产率显著更高(<0.05)。在调整可能的混杂因素后,GH使每个取卵周期的累积活产率提高了1.96倍(=0.032)。此外,当根据年龄和体重指数对患者进行细分时,分别在35至42岁且体重指数≥24kg/m²的(+)GH组患者中发现累积活产率显著增加(<0.05)。GH可能会提高因胚胎发育不良而经历IVF失败的女性的活产率,尤其是肥胖患者和高龄女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d07/9918017/8b7aa1dfa719/jcm-12-00955-g001.jpg

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