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目的:探讨卵巢储备功能下降患者的促排卵优选方案。方法:GnRH-a/hMG/rFSH(Gn)长方案促排卵(A组)共39个周期,GnRH-a/hMG/rFSH(Gn)短方案促排卵(B组)46个周期,GnRH-A/hMG/rFSH(Gn)促排卵(C组)共35个周期,比较3组临床用药和临床结局情况。结果:A组Gn所用天数(12.4±1.51d)显著高于B组(9.5±1.7d)、C组(10.7±3.2),P<0.05,且Gn(75IU/支)所用支数(41.5±8.6支)也明显多于B组(34.7±9.7支)和C组(33.4±16.2支)(P<0.05)。B组Gn所用天数要少于C组(P<0.05),Gn所用总量与C组间无统计学差异(P>0.05)。hCG注射日的血清LH水平A组(1.20±1.02IU/L)显著低于B组(3.17±1.58IU/L)和C组(2.15±1.8IU/L)(P<0.05),B组与C组之间无统计学差异(P>0.05)。A组与C组注射hCG日的血清E2值(7958±4586pmol/L,6022±7852pmol/L)均低于B组(10145±5503pmol/L)(P<0.05)。3组种植率、临床妊娠率均无显著性差异。3组间hCG注射日内膜厚度、受精率、卵裂率均无统计学差异(P>0.05)。结论:短方案更适合于卵巢功能减退患者的促排卵治疗,长方案与GnRH-A方案促排卵也是可行方法。
Objective: To explore ovulation reserve function in patients with ovulation optimization program. Methods: A total of 39 cycles of ovulation induced by GnRH-a / hMG / rFSH (Gn) regimen and 46 cycles of GnRH-a / hMG / rFSH / hMG / rFSH (Gn) ovulation (C group) for a total of 35 cycles, the clinical efficacy and clinical outcomes of the three groups were compared. Results: The days of Gn in group A (12.4 ± 1.51d) were significantly higher than those in group B (9.5 ± 1.7d), group C (10.7 ± 3.2), P <0.05, and the number of Gn (75IU / 8.6) were significantly more than those in group B (34.7 ± 9.7) and group C (33.4 ± 16.2) (P <0.05). The number of days of Gn in group B was less than that of group C (P <0.05). There was no significant difference between the total amount of Gn and group C (P> 0.05). The level of serum LH in group A (1.20 ± 1.02 IU / L) on the day of hCG injection was significantly lower than that in group B (3.17 ± 1.58 IU / L) and group C (2.15 ± 1.8 IU / L) There was no significant difference between C groups (P> 0.05). Serum E2 values (7958 ± 4586pmol / L, 6022 ± 7852pmol / L) of group C and C on hCG day were lower than those of group B (10145 ± 5503pmol / L) (P <0.05). There was no significant difference in implantation rate and clinical pregnancy rate between the three groups. There was no significant difference in intima thickness, fertilization rate and cleavage rate between the three groups on the day of hCG injection (P> 0.05). Conclusions: The short protocol is more suitable for ovulation induction treatment in patients with ovarian dysfunction, and the long protocol and GnRH-A protocol are also feasible methods.