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目的:探讨拮抗剂方案中联合应用促性腺激素释放激素激动剂(Gn RHa)及人绒毛膜促性腺激素(h CG)在接受体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)的患者中诱导卵泡成熟的疗效。方法:共纳入拮抗剂方案促排卵行IVF/ICSI的不孕症患者392例,根据诱导卵泡成熟方法分为Gn RHa联合h CG组(A组,194例)及单用h CG组(B组,198例),观察并计算胚胎情况、妊娠结局及中重度卵巢过度刺激综合征(OHSS)发生率。结果:患者年龄、基础FSH水平、窦卵泡数、促性腺激素(Gn)总使用天数和h CG注射日雌二醇(E2)水平组间差异无统计学意义(P>0.05),A组的卵子成熟率显著高于B组(P<0.05);A组的双原核(2PN)受精率、第3日(D3)优质胚胎率及囊胚形成率均高于B组,差异无统计学意义(P>0.05);生化妊娠率、临床妊娠率、活产率及中重度OHSS发生率组间差异均无统计学意义(P>0.05)。结论:拮抗剂方案中联合应用Gn RHa及h CG诱导卵泡成熟可改善卵子成熟度,进而可能改善胚胎质量。
OBJECTIVE: To investigate the effect of combined use of GnRa and hCG in the IVF / ICSI- ET) to induce follicular maturation in patients. Methods: A total of 392 infertile patients with IVF / ICSI were enrolled in the study. The patients were divided into Gn RHa group (n = 194) and h CG group (group B) , 198 cases), observed and calculated the embryo situation, pregnancy outcome and the incidence of moderate-severe ovarian hyperstimulation syndrome (OHSS). Results: There were no significant differences in age, basic FSH level, antral follicle count, total Gn use days and h CG injection day estradiol (E2) The egg maturation rate was significantly higher in group A than in group B (P <0.05). The fertilization rate of 2PN in group A, the rate of high quality embryo on day 3 and the blastocyst formation rate were all higher than those in group B (P> 0.05). There was no significant difference in biochemical pregnancy rate, clinical pregnancy rate, live birth rate and incidence of moderate-severe OHSS between the two groups (P> 0.05). CONCLUSION: The combination of Gn RHa and h CG in the antagonist regimen to induce follicular maturation can improve egg maturation and thus improve embryo quality.