基础医学与临床 ›› 2022, Vol. 42 ›› Issue (3): 479-483.doi: 10.16352/j.issn.1001-6325.2022.03.005

• 研究论文 • 上一篇    下一篇

促性腺激素释放激素拮抗剂方案比激动剂长方案获得更多可利用胚胎

赵善可, 傅瑶, 褚大鹏, 付磊, 韩烁, 白雪燕, 李媛, 周雯慧*   

  1. 首都医科大学附属北京朝阳医院 生殖医学中心,北京 100020
  • 收稿日期:2021-11-24 修回日期:2021-12-24 出版日期:2022-03-05 发布日期:2022-03-04
  • 通讯作者: * wenhuizhbjcy@126.com

Gonadotropin releasing hormone antagonist protocol brings about more available embryos than agonist long protocol

ZHAO Shan-ke, FU Yao, CHU Da-peng, FU Lei, HAN Shuo, BAI Xue-yan, LI Yuan, ZHOU Wen-hui*   

  1. Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2021-11-24 Revised:2021-12-24 Online:2022-03-05 Published:2022-03-04
  • Contact: * wenhuizhbjcy@126.com

摘要: 目的 分析促性腺激素释放激素(GnRH)拮抗剂方案与传统激动剂长方案,哪种方案能获得更好的胚胎。方法 纳入自2016年1月至2019年12月首次在北京朝阳医院生殖中心进行促排卵的病例,其中传统长方案组1 095例,拮抗剂方案组1 511例,并对相应的指标进行回顾性比较分析,包括受精率、胚胎质量、妊娠结局等。结果 拮抗剂方案组可利用胚胎率(29.94% vs 31.59%)、双原核(2PN)优质胚胎率(44.67% vs 46.86%)、每取卵周期可利用囊胚数/OPU(1±2 vs 1±2)及可利用囊胚率(25.62% vs 29.66%)均显著高于长方案组。结论 与传统长方案相比,拮抗剂方案能给患者带来更多可利用胚胎,加之与长方案类似的妊娠结局以及较低的卵巢过度刺激(OHSS)风险,拮抗剂方案正逐渐成为临床控制性促排卵(卵巢刺激)(COS)方案的首选。

关键词: 促性腺激素释放激素, 激动剂长方案, 拮抗剂方案, 胚胎质量, 妊娠结局

Abstract: Objective To compare the effect on embryo quality from gonadotropin releasing hormone(GnRH) antagonist protocol and from GnRH agonist long protocol, so as to find which protocol works better on embryo quality. Methods A retrospective analysis was performed with a total of 1 095 long protocol cycles and 1 511 antagonist protocol cycles from January 2016 to December 2019. The corresponding fertilization, embryo quality, pregnancy outcomes of the two groups, agonist vs antagonist, were calculated and analyzed. Results Antagonist group displayed significantly higher available embryo rate (29.94% vs 31.59%), good-quality two-pronuclear(2PN) embryo rate (44.67% vs 46.86%), available blastocyst/OPU(ovum pick-up)(1±2 vs 1±2) and available blastocyst rate (25.62% vs 29.66%) than the long protocol group. Conclusions Antagonist protocol may bring about more available embryos than agonist protocol. Together with a similar pregnancy outcome with agonist protocol and its efficacy in reducing ovarian hyperstimulation syndrome(OHSS) risk, antagonist protocol is the first choice for clinical contralled ovarian stimulation(COS) protocol.

Key words: gonadotropin releasing hormone, agonist long protocol, antagonist protocol, embryo quality, pregnancy outcome

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