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目的:探讨不同控制性超促排卵方案对子宫腺肌病患者IVF-ET结局的影响。方法:回顾性分析146例子宫腺肌病患者的192个IVF-ET周期,根据控制性超促排卵(COH)方案分为GnRH-a短方案组(A组,87个周期)、长方案组(B组,34个周期)和超长方案组(C组,71个周期)。比较分析各组的卵巢刺激与胚胎移植结局。结果:3组间年龄及不孕年限无统计学差异(P>0.05);hCG注射日A组LH水平显著高于B、C组,差异显著(P<0.05);各组间获卵数、优质胚胎数、胚胎移植数等无统计学差异(P>0.05);C组的子宫体积在应用长效GnRh-a后明显缩小,差异显著(P<0.05)。促性腺激素(Gn)使用总量C组显著高于A组和B组,差异显著(P<0.05)。临床妊娠率C组(42.6%)显著高于A组(22.4%)和B组(25.8%)(P<0.05)。结论:超长方案可获得与短方案和长方案同样的优质胚胎数,并可提高子宫腺肌病患者IVF-ET临床妊娠率,但Gn用量增加。
Objective: To investigate the effect of different controlled ovarian hyperstimulation protocols on the outcome of IVF-ET in patients with adenomyosis. Methods: A total of 192 IVF-ET cycles in 146 patients with adenomyosis were retrospectively analyzed. Patients were divided into GnRH-a short-term group (A group, 87 cycles) according to controlled ovarian hyperstimulation (COH) (Group B, 34 cycles) and over-long program (group C, 71 cycles). Comparative analysis of ovarian stimulation and embryo transfer outcomes in each group. Results: There was no significant difference in age and duration of infertility between the three groups (P> 0.05). LH level in group A was significantly higher than that in group B and C on the day of hCG injection (P <0.05) There was no significant difference in the number of embryos and embryos (P> 0.05). The volume of uterus in group C was significantly reduced after long-term GnRh-a treatment (P <0.05). The total amount of gonadotropin (Gn) in group C was significantly higher than that in group A and group B (P <0.05). The clinical pregnancy rate in group C (42.6%) was significantly higher than that in group A (22.4%) and group B (25.8%) (P <0.05). CONCLUSIONS: The extra-long-term regimen achieves the same high quality embryo number as the short regimen and long regimen and increases the clinical pregnancy rate of IVF-ET in patients with adenomyosis but increases the use of Gn.