生殖医学杂志2017，Vol.26Issue(6)：503-510,8.DOI:10.3969/j.issn.1004-3845.2017.06.001
高龄患者IVF-ET周期不同促排卵方案的临床结局分析
Analysis of clinical outcome of different ovarian hyperstimulation protocols in advanced patients undergoing IVF-ET
摘要
Abstract
Objective: To investigate the clinical outcome of five different controlled ovarian hyperstimulation (COH) protocols including long,short,antagonist,clomiphene (CC) protocols and natural cycle for the women with advanced age undergoing IVF-ET.Methods: The laboratory and clinical outcomes data of 5 031 cycles including women aged ≥35 years undergone IVF-ET or ICSI with five different COH protocols in our center from 2014 to 2015 were retrospectively analyzed. The patients were divided into three groups according to different ages: 35-39 years,40-42 years,>42 years. The gonadotropin (Gn) dosage,duration,number of oocytes retrieved,MⅡoocytes,number of available embryos,normal fertilization rate,available embryo rate,cycle cancellation rate,clinical pregnant rate in fresh and frozen cycle,early miscarriage rate were compared among the groups.Results: There was no significant difference in the basic condition in the patients of different age with various kinds of COH protocol (P>0.05),expect that the basal FSH and anti-Mullerian hormone (AMH) levels in the natural cycle group was significantly lower than those in the other groups (P<0.05). Among the three different age group,Gn duration was the longest in long protocol group,and Gn dosage was the least in CC protocol (P<0.05). Meanwhile,the cycle cancellation rate in natural cycle was significantly higher than that in other groups (P<0.05). The clinical pregnant rate in short protocol and natural cycle (33.70% and 27.45%) was significantly lower than the other groups in 35-39 years group (P<0.05). The clinical pregnant rate in antagonist protocol and the natural cycle (18.95% and 13.33%) was significantly lower than that of the other groups in 40-42 years group (P<0.05). In the more than 42 years group,there was no significant difference in clinical pregnant rate among five protocols (P>0.05). There was no difference in early abortion rate among the different groups (P>0.05). Conclusions: Clomiphene protocol is worth to recommend for the advanced patients due to its lower dosage and less duration of Gn,and similar clinical pregnancy rate and early abortion rate as long protocol.关键词
高龄/控制性促排卵/体外受精-胚胎移植/临床结局Key words
Advanced age/Controlled ovarian hyperstimulation/IVF-ET/Clinical outcome引用本文复制引用
张雯碧,孙贻娟,陈军玲,李路,孙晓溪..高龄患者IVF-ET周期不同促排卵方案的临床结局分析[J].生殖医学杂志,2017,26(6):503-510,8.基金项目
国家自然科学基金青年基金项目(81501234) （81501234）
