论文部分内容阅读
目的在IVF-ET术中,针对卵巢反应欠佳的患者,采用小剂量GnRHa进行降调节,探讨其临床效果。方法所有患者66例均于使用Gn的前次月经周期优势卵泡排卵后肌肉注射长效GnRHa 0.34mg,达到降调节标准后,开始每日皮下注射短效GnRHa 0.05mg,同时肌肉注射rFSH或HMG,丽珠公司生产,常规取卵及移植。对Gn用量、Gn天数、获卵率、受精率、优质胚胎率及妊娠情况进行观察和统计分析。结果行IVF/ICSI的66例不孕病例共66个治疗周期中,无一出现内源性LH峰,获得较好的临床妊娠率,且所有患者均未出现卵巢过度刺激综合征等其它并发症。结论小剂量的GnRHa方案既可以在黄体晚期募集到质量较高的卵子,又可以在适量的垂体分泌的LH作用下促进卵泡发育和成熟,同时可以防止LH峰提前出现。因此今后临床对于年龄较大和卵巢反应不良的病人考虑使用小剂量的GnRHa进行降调节可能会有较好的治疗效果。
Objective To investigate the clinical effect of low dose GnRHa in IVF-ET for patients with poor ovarian response. Methods All 66 patients were intramuscularly injected with long-acting GnRHa 0.34 mg intramuscularly with GnRHa 0.48 mg after ovulation of the superior menstrual cycle of Gn, and then subcutaneous injection of short-acting GnRHa 0.05 mg was injected subcutaneously daily with rFSH or HMG intramuscularly. Livzon company production, conventional ovulation and transplantation. The amount of Gn, Gn days, the rate of oocyte retrieval, fertilization rate, quality embryo rate and pregnancy were observed and statistical analysis. Results 66 66 infertile cases with IVF / ICSI had no clinical signs of endogenous LH peak, and no clinical complications such as ovarian hyperstimulation syndrome were found in all patients . Conclusions The low-dose GnRHa regimen not only recruits high-quality ova in the late luteal phase but also promotes the follicular development and maturation under the moderate LH secretion. At the same time, the LH peak can be prevented from appearing prematurely. Therefore, in the future for patients with older and poor ovarian response to consider the use of small doses of GnRHa down regulation may have a better therapeutic effect.