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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

22卷

期数:

2016年06期

页码:

499-501

栏目:

临床医学

出版日期:

2016-11-20

文章信息/Info

Title:

Effects of GnRH antagonist protocol and GnRH agonist long protocol on embryo quality and comparison of IVF-ET outcomes

文章编号:

1006-8147（2016）06-0499-3

作者:

王蒙娜¹; 张云山²

（1.天津医科大学研究生院，天津300070；2.天津市中心妇产科医院生殖医学中心，天津300100）

Author(s):

WANG Meng-na¹;  ZHANG Yun-shan²

(1.Graduate School, Tianjin Medical University, Tianjin 300070,China; 2.Reproductive Medicine Center, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300100, China)

关键词:

GnRH-ant方案; GnRH-a长方案; 胚胎质量; 体外受精-胚胎移植

Keywords:

GnRH antagonist protocols;  GnRH agonist long protocols; embryo quality; in vitro fertilization and embryo transfer

分类号:

R321

DOI:

-

文献标志码:

A

摘要:

目的：探讨促性腺激素释放激素拮抗剂（GnRH-ant）方案与促性腺激素释放激素激动剂（GnRH-a）长方案对胚胎质量的影响及体外受精-胚胎移植（IVF-ET）助孕结局的差别。方法：回顾性分析124例接受GnRH-ant方案和477例接受GnRH-a长方案IVF-ET治疗并行新鲜周期移植的患者资料。结果：GnRH-ant方案组Gn天数和Gn用量少于GnRH-a长方案组，差异有统计学意义（P <0.05）。GnRH-a长方案组扳机日雌二醇（E₂）水平高于GnRH-ant方案组，差异有统计学意义（P <0.05）。两组间扳机日卵泡数、≥14 mm卵泡数、孕酮（P）、子宫内膜厚度、获卵数、正常受精数、正常卵裂数、优胚数和可用胚胎数之间差异无统计学意义（P >0.05）。GnRH-ant方案组生化妊娠率及临床妊娠率均高于GnRH-a长方案组，但差异无统计学意义（P >0.05）。结论：GnRH-ant方案可能对胚胎质量无影响。两组间IVF-ET结局无差异，但GnRH-ant方案Gn天数和Gn用量较少，并倾向获得更高的生化妊娠率及临床妊娠率。

Abstract:

Objective: To explore the relationship between different stimulating protocols and embryo quality and the differences in outcomes of IVF-ET. Methods: The data of 124 IVF-ET cycles with GnRH antagonist protocols（A group） and 477 IVF-ET cycles with GnRH agonist long protocols(B group) were analyzed retrospectively. Results: The mean length of stimulation and the dose of gonadotropin in A group were significantly less than B group(P <0.05).The serum Estradiol on the trigger day in B group was significantly higher than A group(P <0.05).The number of ovum, progesterone, the thickness of endometrium on the trigger day and the number of retrieval oocytes, normal-fertilized oocytes, normal-cleavage oocytes, high quality embryos and available embryos did not show statistical differences(P >0.05).The biochemical pregnancy rate and clinical pregnancy rate in A group were higher than B group, but no statistical differences were found(P >0.05). Conclusion: The GnRH antagonist protocol may not have effect on embryo quality. And the outcomes of IVF-ET between the two group have no statistical difference(改为are not significantly different), but the clinical pregnancy rate in GnRH antagonist protocol tends to be higher than GnRH agonist long protocol.

参考文献/References:

[1]Yang S, Chen X, Qiao J, et al. Comparison of GnRH antagonist fixed protocol and GnRH agonists long protocol in infertile patients with normal ovarian reserve function in their first in vitro fertilization-embryo transfer cycle[J]. zhonghua fu chan ke za zhi, 2012,47(4):245

[2]Xing W, Lin H, Li Y, et al. Is the GnRH antagonist protocol effective at preventing OHSS for potentially high responders undergoing IVF/ICSI [J]. PLoS One, 2015,10(10):e0140286

[3]Mu?oz M, Cruz M, Humaidan P, et al. The type of GnRH analogue used during controlled ovarian stimulation influences early embryo developmental kinetics: a time-lapse study[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 168(2):167

[4]Vengetesh P M, Ramachandran A, Kumar P. Choosing GnRH antagonist protocol shows improved oocyte and embryo quality, coherent with the perifollicular vascularity (PFV) in assisted reproductive techniques[J]. J Clin Diagn Res, 2015,9(11):QC24

[5]Lai Q, Zhang H, Zhu G, et al. Comparison of the GnRH agonist and antagonist protocol on the same patients in assisted reproduction during controlled ovarian stimulation cycles[J]. Int J Clin Exp Pathol, 2013, 6(9):1903

[6]Chen S U, Chou C H, Chen M J, et al. Apoptotic effects of high estradiol concentrations on endometrial glandular cells[J]. J Clin Endocrinol Metab, 2014,99(6):E971

[7]Pereira N, Reichman D E, Goldschlag D E, et al. Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles[J]. J Assist Reprod Genet, 2015,32(4):527

[8]Prasad S, Kumar Y, Singhal M, et al. Estradiol level on day 2 and day of trigger: a potential predictor of the IVF-ET success[J]. J Obstet Gynaecol India, 2014,64(3):202

[9]Kummer N, Benadiva C, Feinn R, et al. Factors that predict the probability of a successful clinical outcome after induction of oocyte maturation with a gonadotropin-releasing hormone agonist[J]. Fertil Steril, 2011,96(1):63

相似文献/References:

备注/Memo

备注/Memo:

作者简介 王蒙娜（1990-），女，医师，硕士在读，研究方向：生殖医学；通信作者：张云山，E-mail：tjzys@hotmail.com。

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更新日期/Last Update: 2016-11-25