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目的探讨黄体期改良超长方案在卵巢储备功能低下患者中的临床应用价值。方法回顾性分析2014年8月至2015年7月223例体外受精-胚胎移植的卵巢储备功能低下患者,按应用方案不同分为2组:A组:应用黄体期改良超长方案+人绝经期促性腺激素控制性超排卵,B组:应用微刺激方案促排卵。比较两组患者的一般情况、超促排卵中Gn用量、天数、HCG日E2水平、LH水平、孕酮(P)水平及妊娠结局情况。结果两组患者的临床基础情况无统计学差异(P>0.05)。两组Gn总量(3514.35±1056.50 VS.745.55±260.88)及Gn天数(11.06±1.52 VS.6.21±1.65)比较,差异有统计学意义(P<0.05)。A组获卵数(5.60±2.39)、优胚数(3.59±1.13)、妊娠率(47.75%)及着床率(25.45%)均明显高于B组(分别为2.29±1.23、1.54±0.95、32.04%、16.99%)(P<0.05)。两组周期取消率(0.75%VS.47.18%)比较差异有统计学差异,(P<0.05)。但两组流产率比较,无统计学差异(P>0.05)。结论黄体期改良超长方案,可提高卵巢储备功能低下患者的妊娠结局,是一个经济有效的治疗选择。
Objective To investigate the clinical value of long term modified luteal phase in patients with ovarian reserve dysfunction. Methods A retrospective analysis of 223 ovarian reserve dysfunction patients undergoing in vitro fertilization and embryo transfer from August 2014 to July 2015 was divided into two groups according to the different application schemes: group A: the application of the luteal phase to improve the long term program + menopause Gonadotropin-controlled superovulation, Group B: application of micro-stimulation program to promote ovulation. The general situation, the amount of Gn, the number of days, the level of HC on day E2, the level of LH, the level of progesterone (P) and the outcome of pregnancy were compared between the two groups. Results There was no significant difference in clinical basis between the two groups (P> 0.05). There was significant difference between the two groups (P> 0.05) for the total amount of Gn (3514.35 ± 1056.50 VS.745.55 ± 260.88) and Gn days (11.06 ± 1.52 VS.6.21 ± 1.65). The number of oocytes (5.60 ± 2.39), excellent embryos (3.59 ± 1.13), pregnancy rate (47.75%) and implantation rate (25.45%) in group A were significantly higher than those in group B (2.29 ± 1.23 and 1.54 ± 0.95 , 32.04%, 16.99%) (P <0.05). There was significant difference between the two groups in the cancellation rate (0.75% VS.47.18%) (P <0.05). However, there was no significant difference in abortion rates between the two groups (P> 0.05). Conclusions The luteal phase improved long-term regimen can improve pregnancy outcomes in patients with ovarian reserve dysfunction and is a cost-effective treatment option.