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目的:比较2种人绝经期促性腺激素(h MG)和尿源性卵泡刺激素(u-FSH)联合安宫黄体酮(MPA)对卵巢功能正常患者促排卵的内分泌特征及体外受精/卵胞质内单精子注射(IVF/ICSI)临床结局。方法:回顾性分析258个行IVF/ICSI取卵周期的患者资料,入组患者均采用促性腺激素(Gn)联合MPA方案进行促排卵,根据所使用的Gn药物的类型分为:A组,h MG-A组(商品名:丰原,n=105);B组,h MG-B组(商品名:乐宝得,n=90);C组,u-FSH组(商品名:丽申宝,n=63)。比较3组患者促排卵过程中的卵巢反应、胚胎实验室结局及行冻融胚胎移植(FET)后的妊娠结局。结果:A、B、C组的获卵数分别为12.1±6.9、12.1±5.7、13.1±8.9,3组间比较无统计学差异(P>0.05);3组的成熟卵数、正常受精卵数、卵裂数、可用胚胎数等胚胎实验室指标均无统计学差异(P>0.05);促排卵过程中患者的LH水平维持在0.04~7.38 IU/L之间,未监测到LH峰;FET后,A、B、C组的临床妊娠率(43.48%vs 37.93%vs 40.74%)和种植率(34.88%vs22.22%vs 26.42%)组间比较均无统计学差异(P>0.05)。结论:促排卵过程中加用MPA能够有效抑制早发性LH峰,卵泡期高孕激素状态促排卵(PPOS)为基于FET的促排卵提供了新思路,在PPOS方案中对于卵巢功能正常的患者使用h MG和u-FSH进行促排卵具有相同的临床效果。
Objective: To compare the endocrine characteristics of ovulation induced by two kinds of human menopausal gonadotrophin (h MG) and urinary follicle stimulating hormone (u-FSH) combined with medroxyprogesterone acetate (MPA) and in vitro fertilization / Intramuscular injection (IVF / ICSI) clinical outcome. Methods: The data of 258 IVF / ICSI oocyte retrieval cycles were retrospectively analyzed. All patients were enrolled in the study. Gn combined with MPA was used to induce ovulation. According to the types of Gn drugs used, h group MG-A (trade name: Fengyuan, n = 105); group B, h MG-B Shen Bao, n = 63). Ovarian response during ovulation induction, embryo laboratory outcome and pregnancy outcome after frozen-thawed embryo transfer (FET) were compared between the three groups. Results: The numbers of oocytes in groups A, B and C were 12.1 ± 6.9, 12.1 ± 5.7 and 13.1 ± 8.9, respectively. There was no significant difference between the three groups (P> 0.05). The number of mature eggs, normal fertilized eggs There was no significant difference in the number of embryos in laboratory (P> 0.05), the number of cleavage, the number of available embryos and other embryos in laboratory. The LH level was maintained between 0.04 and 7.38 IU / L during ovulation induction, and the LH peak was not detected. FET, the clinical pregnancy rates (43.48% vs 37.93% vs 40.74%) and the implantation rate in groups A, B and C were not significantly different (P> 0.05) . CONCLUSION: The addition of MPA during ovulation induction can effectively inhibit the occurrence of early LH peak and high progesterone-induced ovulation (PPOS) in follicular phase, which provides a new way to promote ovulation based on FET. In the PPOS program, in patients with normal ovarian function Ovulation with h MG and u-FSH has the same clinical effect.