GnRHa妈富隆双降调节方案在IVF/ICSI中的临床观察

目的:探讨妈富隆+GnRHa双降调节对试管婴儿助孕患者临床结局的影响。方法:回顾性分析179例行IVF/ICSI助孕的患者,随机分成A组:82例,监测排卵后1周应用达菲林1.0 mg降调节,B组:97例,月经第5日口服妈富隆,qd,连用21 d,服药第17日应用达菲林1.0 mg降调节,观察A、B组患者降调节结果、Gn用量、Gn用药时间、获卵数、受精率、卵裂率、临床妊娠率、流产率、OHSS发生率及功能性卵巢囊肿情况。结果:A、B组患者Gn日及hCG注射日LH、E2及P水平无统计学意义;Gn用量、用药天数、获卵数、受精率、卵裂率、临床妊娠率、流产率、OHSS发生率也无统计学意义。但B组患者功能性卵巢囊肿形成率明显低于A组,有统计学意义(P<0.05)。结论:IVF-ET中妈富隆双降调节,避免了多次卵泡监测,适合家不在本地的患者,同时避免了卵泡囊肿的发生,也避免了早期妊娠胚胎暴露在GnRHa中。

Clinical Observation of GnRHa Combined to Marvelon in A Long Protocol of Conrrolled Ovarian Stimulation for IVF/ICSI Embryo Transfer

Objective：To investigate clinical outcome with GnRHa combined to Marvelon in a long protocol of controlled ovarian stimulation for IVF/ICSI embryo transfer.Methods： Retrospective analysis was performed among 179 patients who were randomized into two groups,group A（n=82） received 1.0 mg diphereline depot in a single i.m.injection followed by the 7th day after ovulation（middle of luteal phase）;group B（n=97） took orally Marvelon on menstruate day 5,qd × 21 d.Diphereline 1.0 mg was administered for down-regilation in a single subcutaneous injection on day 17.Serum of hormone levels including luteinizing hormone（LH）,estrogen,progesterone on hCG injection day,Gn dosage,the number of days medicial,egg retrieval count,infertilization rate,cleavage rate,pregnance rate,abortion rate,ovarian hypersimulation syndrome（OHSS） occurrence,functinality ovarian cyst occurrence were observed.Results： Except for functinality ovarian cyst occurrence,the above indicators were not significantly different between the groups.Ovarian cyst incidence rate in group B was lower than that in group A（P〈0.05）.Conclution： Marvelon can adviod many detection by intravagina ultrasound B in a long protocol of controlled ovarian stimulation and functinality ovarian cyst occurrence,prevent early stage of an embryo from exposing in GnRHa.Using Marvelon is suit to the patient who can’t monitor ovulation.