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目的:探讨在控制性卵巢刺激(COS)过程中应用孕激素抑制黄体生成素(LH)峰的临床效果。方法:回顾性分析83例行体外受精/卵胞质内单精子注射-冻融胚胎移植(IVF/ICSI-FET)患者的资料,所有患者均采用孕激素联合促性腺激素方案,83个取卵周期共完成了92个FET周期,统计分析促排卵过程中的激素变化、胚胎实验室情况及妊娠结局。结果:在促排卵过程中,LH持续低水平,基础、中期(月经第9~11日)、诱发排卵当日LH水平分别为3.85±2.03 IU/L、3.64±2.01 IU/L、2.62±1.77 IU/L,未监测到LH峰。h MG的用药剂量为1 964.76±468.73 IU,孕激素(商品名:安琪坦)的用药剂量为2.05±0.34 g。平均获卵数为10.9±6.1,每个取卵周期平均冷冻5.0±2.5个胚胎。FET后临床妊娠率为52.17%(48/92),胚胎种植率为39.34%(72/183),流产率为10.42%(5/48)。结论:孕激素能够有效抑制LH峰,孕激素联合Gn促排卵方案为基于FET的促排卵技术提供了新的备选方案。
Objective: To investigate the clinical effect of progestin on inhibiting LH peak in control ovary stimulation (COS). Methods: The data of 83 IVF / ICSI-FET patients who underwent in vitro fertilization / intracytoplasmic sperm injection were retrospectively analyzed. All patients received progestin plus gonadotropin regimen and 83 ovulation cycles A total of 92 FET cycles were completed, and the hormonal changes during ovulation induction, embryo laboratory conditions and pregnancy outcomes were statistically analyzed. Results: During the process of ovulation induction, the levels of LH remained low, basal and metaphase (menstrual days 9 to 11), and the LH levels on the day of ovulation induction were 3.85 ± 2.03 IU / L, 3.64 ± 2.01 IU / L and 2.62 ± 1.77 IU / L, LH peak not detected. The dose of h MG was 1 964.76 ± 468.73 IU and the dose of progestin (trade name Angelina) was 2.05 ± 0.34 g. The average number of oocytes retrieved was 10.9 ± 6.1, with an average of 5.0 ± 2.5 embryos per egg retrieval cycle. The pregnancy rate after FET was 52.17% (48/92), embryo implantation rate was 39.34% (72/183) and abortion rate was 10.42% (5/48). Conclusion: Progesterone can effectively inhibit the LH peak, progesterin combined with Gn ovulation ovulation-based FET-based technology provides a new alternative.