卵巢储备功能减退患者继续黄体期促排卵的临床观察

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目的:探讨卵巢储备功能减退的不孕症患者在辅助生殖助孕中卵泡期促排卵后继续行黄体期促排卵的可行性。方法:回顾性分析行体外受精/卵胞质内单精子显微注射(IVF/ICSI)助孕在卵泡期促排取卵后,继续于黄体期给予促性腺激素(Gn)促排卵65名卵巢储备功能减退患者的临床资料,分析获卵数、受精率及优质胚胎数等,所得可用胚胎均行全部胚胎冷冻。结果:65个黄体期促排卵周期中,3个周期未获卵,总获卵数为158个,平均获卵数为2.5±1.1个,受精率为74.1%,共获得优质胚胎数为53个,行全部胚胎冷冻。比较34例患者卵泡期拮抗剂方案和黄体期促排卵效果,黄体期促排卵MII卵获得率高,Gn用量少,h CG注射日黄体生成素(LH)值低,孕酮(P)值高,差异有统计学意义(P<0.05),h CG注射日雌二醇(E2)值、促排卵天数、受精率及优质胚胎率组间差异无统计学意义。结论:卵巢储备功能减退的患者在IVF常规卵泡期促排卵中常出现优势卵泡少、空卵泡及提前排卵等不良结局,在优势卵泡取出或排卵后继续行黄体期促排卵可获得理想的卵子和优质胚胎数,为后续冻融胚胎移植提供可用胚胎,是一种安全可行的补充方案。 OBJECTIVE: To investigate the feasibility of promoting ovulation in the luteal phase after ovulation induction in follicular phase assisted by assisted reproductive pregnancy in patients with infertility with ovarian reserve loss. Methods: Retrospective analysis of in vitro fertilization / intracytoplasmic sperm injection (IVF / ICSI) assisted pregnancy in the follicular phase to promote ovulation, and continued in the luteal phase to give gonadotropin (Gn) ovulation 65 ovarian reserve Clinical data of patients with hypothyroidism, analysis of the number of oocytes retrieved, fertilization rate and the number of high-quality embryos, the available embryos obtained from all embryos frozen. Results: During the ovulation period of 65 luteal phase, no ovulation occurred in 3 cycles, and the total number of oocytes retrieved was 158, the average number of oocytes retrieved was 2.5 ± 1.1 and the fertilization rate was 74.1%. The total number of high quality embryos obtained was 53 , All the embryos frozen. Comparison of 34 patients with follicular phase antagonist programs and luteal phase ovulation induction effect, luteal phase ovulation MII eggs obtained rate, Gn dosage, h CG injection day luteinizing hormone (LH) value, progesterone (P) value The difference was statistically significant (P <0.05). The values ​​of estradiol (E2), ovulation induction days, fertilization rate and high quality embryos rate on h CG injection day were not statistically significant. CONCLUSIONS: In patients with ovarian reserve dysfunction, frequent follicles, empty follicles, and early ovulation often occur during ovulation induction in IVF. Ideal ovulation and quality can be obtained by continuing ovulation induction in the luteal phase after the superior follicles are taken out or ovulation The number of embryos, providing embryos for subsequent freeze-thaw embryo transfer, is a safe and feasible supplement.
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