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目的探讨高纯度人绝经期促性腺激素(HP-HMG)在体外受精-胚胎移植(IVF-ET)促排卵治疗中的有效使用方法。方法回顾性分析2013年1月5日至10月30日于中信湘雅生殖与遗传专科医院行IVF-ET助孕的298名患者的临床资料,根据促排卵药物的不同分成2组:单纯使用HP-HMG的138人为第1组,使用重组FSH(rFSH)和HP-HMG的160人为第2组。比较两组患者促排卵过程中卵巢反应、激素水平、用药情况及治疗结局。结果第2组Gn第6天的E2水平[(2 923.06±430.64)pmol/L]显著高于第1组[(2 218.44±1 745.86)pmol/L](P<0.05)。第1组HCG日及Gn第6天HCG水平、总Gn用量和Gn天数明显高于第2组[(分别为(1.79±0.78)U/L vs.(0.89±0.59)U/L,(1.38±1.03)U/L vs.(0.48±0.35)U/L,(1 623.02±547.08)U vs.(1 287.53±498.58)U,(9.89±1.57)d vs.(9.35±1.48)d](P<0.05)。两组患者的平均获卵数、受精数、优胚数、早期流产率、取消率、中重度卵巢过度刺激综合征(OHSS)发生率、OHSS取消率、宫外孕发生率比较均无显著性差异(P>0.05)。第2组患者的妊娠率、着床率和活产率显著高于第1组(分别为81.06%vs.67.29%,62.25%vs.46.60%,74.24%vs.59.81%)(P<0.05)。结论在IVF-ET治疗中,使用rFSH和HP-HMG联合促排卵可以获得比单纯应用HP-HMG较高的临床妊娠率。
Objective To investigate the effective use of high purity human menopause gonadotropin (HP-HMG) in ovulation induction by IVF-ET. Methods The clinical data of 298 pregnant women assisted by IVF-ET in CITIC Xiangya Reproductive and Genetic College from January 5 to October 30, 2013 were retrospectively analyzed. According to the ovulation-promoting drugs, they were divided into 2 groups: simple use 138 of HP-HMG were in group 1, 160 in group 2 were using recombinant FSH (rFSH) and HP-HMG. Ovarian response, hormone levels, medication and treatment outcomes during ovulation induction were compared between the two groups. Results The E2 level of Gn on day 6 in group 2 [(2923.06 ± 430.64) pmol / L] was significantly higher than that in group 1 [(2 218.44 ± 1745.86) pmol / L] (P <0.05). HCG level, total Gn dosage and Gn days on HCG day 1 and Gn day 6 in group 1 were significantly higher than those in group 2 (1.79 ± 0.78 U / L vs. 0.89 ± 0.59 U / L, 1.38 ± 1.03) U / L vs. (0.48 ± 0.35) U / L, (6223.02 ± 547.08) U vs. (1289.53 ± 498.58) U, (9.89 ± 1.57) d vs. (9.35 ± 1.48) d] P <0.05) .The average number of oocytes retrieved, number of fertilization, number of excellent embryos, rate of abortion, rate of abortion, incidence of moderate-severe ovarian hyperstimulation syndrome (OHSS), rate of OHSS abolition, and incidence of ectopic pregnancy The pregnancy rate, implantation rate and live birth rate in group 2 were significantly higher than those in group 1 (81.06% vs.67.29%, 62.25% vs.46.60%, 74.24% respectively, P <0.05) vs.59.81%, respectively) (P <0.05) .Conclusion The combination of rFSH and HP-HMG in ovulation induction can achieve a higher clinical pregnancy rate than HP-HMG alone in the treatment of IVF-ET.