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目的探讨长效和短效促性腺激素释放激素激动剂(GnRH-a,达菲林)在控制性超排卵长方案中的应用及其对临床结局的影响。方法回顾性分析长方案控制性超排卵362例患者的临床资料,按使用达菲林剂型的不同分为两组:A组170例采用长效达菲林1.0-1.5mg单次注射降调节;B组192例采用短效达菲林0.1mg/d降调节,比较两组间降调情况,促性腺激素(Gn)用量,Gn天数,获卵数,优胚率,妊娠率,种植率,流产率,卵巢过度刺激综合征(OHSS)发生率等。结果两组间对比,Gn用量,受精率,优胚率,临床妊娠率,流产率均无统计学差异(P>0.05),A组降调时间,Gn天数,获卵数,胚胎种植率,OHSS发生率均高于B组,差异有统计学意义(P<0.05)。结论在控制性超排卵长方案中应用长效和短效GnRH-a均能达到有效的降调节,获得相似的妊娠率,但长效GnRH-a垂体抑制更深,Gn刺激时间长,OHSS风险增高。
Objective To investigate the application of long-acting and short-acting gonadotropin-releasing hormone agonist (GnRH-a) in long-term controlled ovarian hypersecretion and its effect on clinical outcomes. Methods The clinical data of 362 patients with long-term controlled ovarian hyperstimulation were retrospectively analyzed. According to the different dosage forms of DF, the treatment group was divided into two groups: 170 cases in group A were treated with 1.0-1.5 mg long-acting Tamiflu in a single injection, while in group B 192 patients were treated with short-acting danfranin 0.1 mg / d. The levels of gonadotrophin (Gn), days of Gn, number of oocytes retrieved, rate of excellent embryo, pregnancy rate, implantation rate, abortion rate, Ovarian hyperstimulation syndrome (OHSS) incidence and so on. Results There was no significant difference in Gn dosage, fertilization rate, excellent embryo rate, clinical pregnancy rate and miscarriage rate between the two groups (P> 0.05). The time of group A decreased, the number of Gn days, the number of oocytes retrieved, the rate of embryo implantation, The incidence of OHSS was higher than that of group B, the difference was statistically significant (P <0.05). Conclusion Long-acting and short-acting GnRH-a can achieve effective down-regulation and achieve similar pregnancy rates in long-term controlled long-term and long-term GnRH-a regimens. However, the long-acting GnRH-a pituitary is inhibited more deeply and Gn is stimulated for a longer time and the risk of OHSS is increased .