口服避孕药在控制性超排短／超短方案中的应用研究

目的]探讨在短/超短降调节方案中使用口服避孕药预处理的作用.方法]回顾性分析2008年8月至2009年1月在本院接受体外受精（IVF）或卵细胞浆单精子注射（ICSI）助孕的不孕症患者400例,控制性超排卵方案均为短/超短方案垂体降调节,短效避孕药处理组（A组）150例;未处理组（B组）250例.比较两组超排天数、血清激素水平、成熟（MⅡ）卵子数,受精率,优胚率,妊娠率.结果]A组超排天数（9.26±1.74） d与B组（8.82±1.52） d比较有显著性差异（ P ＜0.05）;周期d2 两组卵泡刺激素（FSH）、黄体酮（P）比较有显著性差异（P＜0.05）;超排d4两组黄体生成素（ LH ）、 P比较有显著性差异（ P ＜0.05）;注射HCG日两组 LH、催乳素（PRL）比较有显著性差异（P〈0.05）;MⅡ卵子数、受精率、优胚率和妊娠率均无显著性差异（P〉0.05）.结论]在控制性短/超短方案降调节中,使用短效避孕药进行预处理,对超排周期各时期的内分泌均有改变,延长了超排周期时间,促性腺激素（Gn）的用量没有差异.

Application of Oral Contraceptive Pill in Short or Super-short Protocol of Controlled Ovarian Hyperstimulation

Objective] To investigate the role of oral contraceptive pill（OCP） pretreatment in short or supe-short protocol of downregulation of controlled ovarian hyperstimulation（COH）. Methods] Totally 400 infertile patients receiving in-vitro fertilization（IVF） or intracytoplasmic sperm injection（ICSI） for the assisted reproduction in our hospital from Aug. 2008 to Jan. 2009 were analyzed retrospectively. Group A（ n = 150） received short-term OCP pretreatment in short or super-short protocol of downregulation of COH. Group B（ n =250） was not given pretreatment. The days of COH, serum levels of hormones, the number of mature o vum, the fertility rate, good-quality embryo rate and pregnancy rate were compared between two groups. Results] The days of COH in Group A and group B were 9.26±1.74d and 8.82±1.52d, and there was significant difference between two groups （ P 〈0. 05）. In the d2-cycle, there was significant difference in follicle stimulating hormone（FSH） and progesterone（P） between two groups（ P 〈0.05）. At d4 of COH, there was significant difference in luteinizing hormone（LH） and P between two groups（ P 〈0.05）. At the day of human chorionic gonadotrophin（HCG） injection, there was significant difference in LH and prolactin（PRL） between two groups（ P 〈0.05）. However, there were no significant differences in the number of mature ovum, fertility rate, good-quality-embryo rate and pregnancy rate（ P 〉0. 05）. Conclusion]The use of OCP pretreatment in short or super-short protocol of downregulation of COH can change the endocrine at each stage of COH cycle and prolong the duration of COH, but not alter the dosage of gonadotrophic hormone（Gn）.