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目的:探讨3种控制性促排卵方案治疗卵巢反应不良年轻患者的效果。方法:回顾分析2009年6月至2011年7月在中山大学附属第一医院生殖中心行辅助生育治疗、年龄30～40岁、出现2次及以上卵巢反应不良周期患者的所有周期共240个,选取其中标准GnRH激动剂长、短及拮抗剂方案共220个周期。在220个周期中GnRH激动剂长方案86个周期为长方案组、短方案83个周期为短方案组、拮抗剂方案51个周期为拮抗剂方案组。比较3组病例的临床资料、实验室资料和妊娠结局,评估不同促排卵方案治疗卵巢反应不良的结果。结果:短方案组基础FSH高于长方案组(P=0.039),但Gn总量少于长方案组(P=0.000),两组胚胎质量及妊娠结局的差异无统计学意义。短方案组基础FSH与拮抗剂方案组的差异无统计学意义,虽然Gn使用量高于拮抗剂方案组(P=0.000),但获卵数亦高于拮抗剂方案组(P=0.001),且周期取消率低于拮抗剂方案组(P=0.013)。3组其他临床资料(年龄、不孕年限等)、受精数、受精率、可利用胚胎率、胚胎种植率及妊娠结局等差异均无统计学意义(P>0.05)。比较添加生长激素对长、短方案获卵数的影响,差异无统计学意义(P>0.05)。结论:GnRHa短方案用于小于40岁的卵巢反应不良患者的促排卵效果较优。
Objective: To investigate the effect of three controlled ovulation induction regimens in treating young patients with poor ovarian response. Methods: Retrospective analysis from June 2009 to July 2011 at the First Affiliated Hospital of Sun Yat-sen Reproductive Center line assisted reproductive treatment, aged 30 to 40 years old, there are two or more cycles of ovarian dysfunction in patients with a total of 240 cycles, The selection of standard GnRH agonist long, short and antagonist programs a total of 220 cycles. Eighty-six cycles of long GnRH agonist regimens in 220 cycles were long regimen, short regimen of 83 cycles were short regimen, and antagonist regimen was 51 cycles of antagonist regimen. The clinical data, laboratory data and pregnancy outcomes of three groups were compared to evaluate the results of different ovulation induction programs in treating ovarian failure. Results: The basal FSH of the short-term group was higher than that of the long-term group (P = 0.039), but the total Gn was less than that of the long-term group (P = 0.000). There was no significant difference in embryo quality and pregnancy outcome between the two groups. There were no significant differences between the two groups (P = 0.000), but the number of oocytes retrieved was also higher than that of the antagonist group (P = 0.001), although the use of Gn was higher than that of the antagonist group (P = 0.000) And the cancellation rate was lower than that of the antagonist group (P = 0.013). There were no significant differences in other clinical data (age, duration of infertility, etc.), fertilization rate, fertilization rate, available embryo rate, embryo implantation rate and pregnancy outcome among the three groups (P> 0.05). Compared with the effect of adding growth hormone on the number of oocytes retrieved by long and short protocols, the difference was not statistically significant (P> 0.05). Conclusion: GnRHa short regimen is effective in ovulation induction in patients with ovarian dysfunction less than 40 years old.