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目的比较体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)中促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,GnRHa)短方案与促性腺激素释放激素拮抗剂(gonadotropin-releasing hormone antagonists,GnRH-ant)方案治疗多囊卵巢综合征(polycystic ovary syndrome,PCOS)高龄女性患者的妊娠结局。方法回顾性分析2014年1月至2016年1月于海南医学院附属医院生殖医学中心行首次IVF-ET助孕的年龄≥35岁的PCOS患者333个周期,采用短方案治疗的163个周期,拮抗剂方案170个周期,比较两组患者基本情况、体质量指数、基础卵泡刺激素、基础黄体生成素、促性腺激素用药总量及总天数、获卵数、可移植胚胎数、优质胚胎数、临床妊娠率。结果拮抗剂方案组的临床妊娠率(50.0%)和促性腺激素使用总天数[(8.97±3.22)d]高于短方案组[34.30%、(8.17±2.90)d](P<0.05);两组其余指标比较差异均无统计学意义(P>0.05)。结论高龄PCOS患者IVF-ET助孕拮抗剂方案优于短方案,因此在制定高龄女性的PCOS促排卵方案时可优先考虑拮抗剂方案。
Objective To compare the effects of gonadotropin-releasing hormone agonist (GnRHa) short-term regimen and gonadotropin-releasing hormone (Gonadotropin-releasing hormone) antagonist in vitro fertilization-embryo transfer (IVF- hormone antagonists, GnRH-ant) regimen in pregnant women with polycystic ovary syndrome (PCOS). Methods A retrospective analysis of 333 cycles of PCOS patients ≥35 years of age at the first IVF-ET cohort of Reproductive Medicine Center of Affiliated Hospital of Hainan Medical College from January 2014 to January 2016 was performed. 163 cycles of short-term treatment were retrospectively analyzed. Antagonist regimen for 170 cycles. The basic situation, body mass index, basal follicle stimulating hormone, basal LH, gonadotrophin dosage and total days, the number of oocytes retrieved, the number of transferable embryos, the number of high quality embryos Clinical pregnancy rate. Results The clinical pregnancy rate (50.0%) and the total number of days of gonadotropin use [(8.97 ± 3.22) d] in the antagonist group were higher than those in the short - term group [34.30%, 8.17 ± 2.90] d (P <0.05). There was no significant difference between the two groups (P> 0.05). CONCLUSIONS: IVF-ET in the elderly PCOS patients are better than the short-course IVF-ET in helping pregnant women with PCOS. Therefore, the antagonist program may be prioritized in the development of PCOS ovulation induction programs in elderly women.