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目的:探讨低剂量促性腺激素释放激素激动剂(GnRH-a)改良超长降调节对体外受精/卵胞浆内单精子注射—胚胎移植术(IVF/ICSI-ET)结局的影响。方法 :选择既往已行IVF/ICSI-ET 1~3周期未孕患者226例,其中A组多囊卵巢综合征(PCOS)患者86例,B组卵巢低反应患者43例,C组单纯输卵管因素或男方因素患者97例,所有患者在前一周期中均为常规长方案促排卵。在本周期中均采用改良超长方案,两次降调节达菲林用量均小于或等于1.25 mg(1/3支),比较3组患者前、后两个不同促排卵周期超促排卵天数、Gn用量、启动日及h CG日血清激素水平、获卵数、优质胚胎率、临床妊娠率等。结果:3组患者前、后两个周期h CG日E2值及P值、h CG日子宫内膜厚度、获卵数、受精率、优质胚胎率比较差异无统计学意义(P>0.05);3组的改良超长周期Gn总剂量C组增加,A、B两组减少,但差异均无统计学意义(P>0.05);启动日FSH值、胚胎着床率、临床妊娠率改良超长周期较长方案周期高,Gn天数缩短,差异均有统计学意义(P<0.05)。结论:低剂量降调节改良超长方案对于大多数患者是一种有效、经济的促排卵方案。
OBJECTIVE: To investigate the effect of modified long-term hypogonadal regulation (GnRH-a) on the outcomes of in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF / ICSI-ET). Methods: A total of 226 IVF / ICSI-ET non-pregnant women aged 1 to 3 cycles were enrolled. Among them, 86 cases were diagnosed as polycystic ovary syndrome (PCOS) in group A, 43 cases were ovariectomized in group B, Or male factor in patients with 97 cases, all patients in the previous cycle are routine long-term ovulation induction. During this period, the modified long-term regimen was adopted and the dose of diphtheline decreased by two times to less than or equal to 1.25 mg (1/3). The days of superovulation in two different cycles of ovulation induction were compared before and after Gn Dosage, start date and h CG day serum hormone levels, number of oocytes retrieved, high quality embryo rate, clinical pregnancy rate and so on. Results: There were no significant differences in E2 value and P value of h CG day, endometrial thickness of h CG day, number of oocytes retrieved, fertilization rate and quality embryo before and after the two cycles in the three groups (P> 0.05). The total dose of Gn increased in group C and group A, B, but the difference was not statistically significant (P> 0.05). The FSH value on embryo day, embryo implantation rate and clinical pregnancy rate improved significantly Period longer cycle duration, Gn days shortened, the difference was statistically significant (P <0.05). CONCLUSIONS: Low-dose-down-regulation improves long-term regimens as an effective and economical ovulation-promoting regimen for most patients.