来曲唑促排卵在卵巢低反应患者中的应用

目的探讨来曲唑促排卵对IVF-ET卵巢低反应患者妊娠结局的影响。方法回顾性分析IVF-ET卵巢低反应患者应用来曲唑促排卵的62个周期(A组),随机选取同期年龄35岁应用短效GnRH-a降调后促排卵的长方案62个周期作为对照(B组)。比较两组患者临床资料、获卵、受精及妊娠情况。结果 A组Gn治疗时间及总剂量均显著低于B组(P0.01);A组HCG日子宫内膜厚度、E2及P水平均显著低于B组,LH水平显著高于B组(P0.01);A组未获卵周期率高于B组,平均获卵数及可移植胚胎数均显著低于B组(P0.01),但受精率及卵裂率两组无显著性差异(P0.05);A组取消周期率显著高于B组(P0.01),临床妊娠率/取卵周期显著低于B组(P0.01),但两组的胚胎种植率、临床妊娠率/移植周期及流产率无显著性差异(P0.05)。结论来曲唑促排卵获得卵母细胞数目少,但受精及卵裂情况较好;而且对子宫内膜影响小,适宜受精卵着床,适合于卵巢低反应的IVF-ET患者。

Application of letrozole for ovulation induction in patients with poor ovarian response

Objective：To investigate the effect of letrozole for ovulation induction in patients with poor ovarian response during in vitro fertilization-embryo transfer（IVF-ET）.Methods：The data of 62 cycles from infertile patients who accepted letrozole for ovulation induction in IVF-ET（group A）were retrospective1y analyzed.Another 62 cycles as the control （group B）were randomly selected from the infertile patients who were older than 35 years and underwent IVF-ET with shot GnRH-agonist （GnRH-a）and gonadotropin （Gn）for ovulation induction.The clinical data and pregnancy outcomes,such as the number of oocytes retrieved,fertilization rate,embryo implantation rate and clinical pregnancy rate,were compared between the two groups.Results：The duration and dose of Gn used in group A were significantly less than those in group B （P〈0.01）.The endometrial thickness and the levels of serum estradiol （E2）or progesterone on human chorionic gonadotrophin（HCG）injection day in group A were significantly less than those in group B（P〈 0.01）.Otherwise,the levels of serum luteinizing hormone（LH）in group A were significantly higher than those in group B（P〈0.01）.The rate of no oocytes retrieved cycle in group A was significantly higher than that in group B（P〈0.01）.The number of oocytes retrieved and high-quality embryo number in group A were significantly lower than those in group B（P〈0.01）.However,no statistical difference was found in fertilization rate and cleavage rate between the two groups（P〉0.05）.Cancel cycle rate in group A was significantly higher level than that in group B（P〈0.01）.The clinical pregnancy rate of oocytes retrieved cycles in group A was significantly lower than that in group B（P〈0.01）,but there was no statistical difference in embryo implantation rate,the clinical pregnancy rate of transplantation cycles,and abortion rate between the two groups（P〉0.05）.Conclusions：In the cycles with using letrozole for ovulation induction cycles,