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目的:探讨卵巢储备正常者在促排卵不同阶段添加高纯度人绝经期促性腺激素(highly purified human menopausal gonadotrophin,HP-h MG)对体外受精-胚胎移植(IVF-ET)结局的影响。方法:收集接受IVF或单精子胞质内显微注射技术(ICSI)治疗的25~35岁卵巢储备功能正常的患者(n=153),根据是否添加HP-h MG及添加时机分为A组(未添加HP-h MG),B组(Gn第1日添加HP-h MG)和C组(Gn第6~8日添加HP-h MG),分析三组妊娠结局。结果:A组h CG注射日LH、E_2水平低于B组及C组(P<0.05),A组h CG注射日P水平高于B组及C组(P<0.05),获卵数及M_Ⅱ卵子数A组及C组高于B组(P<0.05),优质胚胎率B组高于A组及C组(P<0.05),累积妊娠率,C组(85%)高于A组(59.3%)及B组(67.6%),差异有统计学意义(P<0.05),3组受精率、成熟卵率、种植率差异无统计学意义(P>0.05)。结论:卵巢储备功能正常者在采用标准长方案促排卵时,中晚期添加HP-h MG可改善累积妊娠结局;卵泡发育不同阶段添加HP-h MG,可能适用于不同的人群。
Objective: To investigate the effect of highly purified human menopausal gonadotrophin (HP-h MG) on the outcome of in vitro fertilization-embryo transfer (IVF-ET) in ovariectomized women with normal ovarian reserve. METHODS: Patients with normal ovarian reserve aged 25-35 years (n = 153) undergoing IVF or intracytoplasmic sperm injection (ICSI) were enrolled in this study. Patients were divided into group A (Without HP-h MG), group B (HP-h MG added on the first day of Gn) and group C (HP-h MG added on the 6th to the 8th day of Gn). Results: The levels of LH and E_2 in group A at the day of h CG injection were lower than those in group B and C (P <0.05). The level of P at h CG injection in group A was higher than that in group B and C (P <0.05) The number of M_Ⅱ eggs in group A and group C was higher than that in group B (P <0.05), the rate of high quality embryo in group B was higher than that in group A and C (P <0.05), and the cumulative pregnancy rate was higher in group C (85% (59.3%) and group B (67.6%), the difference was statistically significant (P <0.05). There was no significant difference in fertilization rate, mature egg rate and implantation rate between the three groups (P> 0.05). Conclusion: Ovarian reserve normal function in the use of standard long-term ovulation induction, the late addition of HP-h MG can improve the cumulative pregnancy outcome; different stages of follicular growth HP-h MG may be applicable to different populations.