附属第一医院生殖中心,广东,广州,510080
网络首发:2017-03-16,
纸质出版:2017
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罗颖怡, 邓明芬, 胡晓坤, 等. 不同降调节长方案GnRH-a 剂量与LH 水平的关系 及临床结局的比较[J]. 中山大学学报(医学科学版), 2017,38(2).
LUO Ying-yi, DENG Ming-fen, HU Xiao-kun, et al. Relation between Dosage of GnRH-a and Serum LH Levels and Comparison of Clinical Outcomes among Different GnRH-a Long Protocols[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(2).
罗颖怡, 邓明芬, 胡晓坤, 等. 不同降调节长方案GnRH-a 剂量与LH 水平的关系 及临床结局的比较[J]. 中山大学学报(医学科学版), 2017,38(2). DOI:
LUO Ying-yi, DENG Ming-fen, HU Xiao-kun, et al. Relation between Dosage of GnRH-a and Serum LH Levels and Comparison of Clinical Outcomes among Different GnRH-a Long Protocols[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(2). DOI:
【目的】观察不同剂量促性腺激素释放激素激动剂(GnRH-a)降调节长方案黄体生成素(LH)水平在超促排卵 过程中的动态变化,探讨GnRH-a 用量与超排卵过程中LH水平的关系,同时比较各方案的妊娠结局。【方法】回顾性分析 2015年1月至2015年6月中山大学附属第一医院生殖中心采用1.0、0.8、0.375 mg长效长方案及0.1、0.05 mg/d短效长方案降 调节的周期共250例,每组50例,比较分析黄体期使用不同剂量GnRH-a后在开始促排卵当天(Gn0)、促排卵第4天(Gn4)、 促排卵第7 天(Gn7)及注射HCG 日(HCG 日)的LH 水平在不同方案之间的差异,比较各组获卵数、正常受精率、优质胚胎 率、囊胚移植率、移植胚胎数、种植率及临床妊娠率。【结果】长效长方案中,0.375 mg组在超排卵过程中各时间点的LH水平 均高于1.0及0.8 mg组(P < 0.05);1.0、0.8 mg组的Gn使用时间、总Gn用量及HMG用量明显大于0.375 mg组,差异均具统计 学意义(P < 0.05);LH水平越高,胚胎种植率有增加的趋势,无统计学差异(P > 0.05);短效长方案中,0.1 mg/d组超排卵过 程各时间点的LH水平高于0.05 mg/d组,在Gn0、Gn7及HCG日差异均具统计学意义(P < 0.05);Gn使用时间、总Gn用量及 HMG用量在两组间无统计学差异(P > 0.05)。0.1 mg/d组比0.05 mg/d组胚胎种植率高,无统计学差异(P > 0.05)。【结论】长 效长方案中,超排卵过程中的LH水平及胚胎种植率随着GnRH-a用量的减少而升高;短效长方案中,0.1 mg/d组的LH水平 和胚胎种植率较0.05 mg/d组高。
Abstract:【Objective】To observe the dynamic changes of serum LH levels in different GnRH-along protocols,and investigate the relationship between GnRH-adosage and LH levels,and compare the clinical outcomes among different GnRH-a long protocols. 【Methods】In this retrospective study,1.0 mg,0.8 mg,0.375 mg long-acting and 0.1 mg/d,0.05 mg/d short-acting GnRH-a long protocols were included from January to June in 2015 at the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat- Sen University. Serum LH levels were evaluated from a total of 250 women at the four time points,on the day before gonadotropin stimulation(Gn0),the fourth day of Gn stimulation(Gn4),the seventh day of Gn stimulation(Gn7),and the HCG administration day(HCG day),then the relationship between serum LH levels and the dosage of GnRH-a were analyzed. The number of oocytes retrieved,fertilization rate,good quality embryos rate,blastocyst transferred rate,the number of transferred embryos,implantation rate and clinical pregnancy rate were also compared.【Results】Among the long-acting groups,LH levels in 0.375 mg group werehigher than those in 1.0 mg and 0.8 mg groups at the four time points(P < 0.05). Total Gn dose,duration of Gnstimualtion and HMG dosage of 1.0 mg protocol and 0.8 mg protocol were significantly higher than those of 0.375 mg group(P < 0.05). In addition,the implantation rate showed an increasing tendency when the level of LH increases(P > 0.05). In short-acting groups,the LH levels in 0.05 mg/d protocol were significantly lower than those in the 0.1 mg/d group at Gn0
Gn7 and HCG day(P < 0.05). Total Gn dose,du? ration of Gn stimulation and HMG dosage did not show significant difference between 0.05mg and 0.1mg group. What′s more,the im? plantation rate in 0.1 mg/d group was higher than in 0.05 mg/d group(P > 0.05).【Conclusion】Among the long-acting groups,the smaller amount of GnRH-a was administrated,the higher LH levels during ovarian stimulation and implantation rate the patients ob? tained. As to the short-acting groups,the LH level and implantation rate in 0.1 mg/d group is higher than those in 0.05 mg/d group.
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