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GnRH-a联合低剂量HCG诱发卵母细胞成熟在行PGD/PGS助孕患者中的应用
干润新;李元;罗克莉;龚斐
0
(中南大学基础学院生殖与干细胞研究所; 中信湘雅生殖与遗传专科医院)
摘要:
目的:探讨促性腺激素释放激素拮抗剂(GnRH-ant)方案中促性腺激素释放激素激动剂(GnRH-a)联合低剂量绒促性素(HCG)扳机对行胚胎植入前遗传学诊断/筛查(PGD/PGS)助孕患者促排卵的效果。方法:回顾性分析2015年1月至2016年3月在我院因女方染色体异常行GnRH-ant方案中GnRH-a联合低剂量HCG双扳机诱导卵泡成熟的PGD/PGS助孕患者79例(A组),根据年龄、抗苗勒管激素(AMH)、基础卵泡刺激素(FSH)匹配选取行拮抗剂方案促排卵并单纯使用HCG扳机诱导卵泡成熟患者79例(B组)作对照,比较两组促排卵特点及促排卵结局。结果:两组促性腺激素总量、促排天数、HCG日雌二醇(E2)、HCG日孕酮(P)、HCG日黄体生成素(LH)、回收卵数、2个原核(2PN)数、第3天(D3)胚胎数、活检正常胚胎数、新发异常率差异均无统计学意义(P>0.05)。与B组相比,A组获成熟卵数、D3优质胚胎数、形成囊胚数、优质囊胚数及优质囊胚率明显升高(P<0.05),检测后正常的胚胎数虽然两组差异无统计学意义,但A组有升高趋势,两组OHSS发生率无明显差异(P>0.05)。结论:GnRH-ant方案中GnRH-a联合HCG诱发卵母细胞成熟改善了行PGD/PGS助孕患者促排结局。
关键词:  促性腺激素释放激素拮抗剂  促性腺激素释放激素激动剂  绒促性素  胚胎植入前遗传学诊断/筛查
DOI:
基金项目:
Application of GnRH-agonist and Low-dose HCG for Final Oocyte Maturation in PGD/PGS Patients with Gonadotrophin Releasing Hormone Antagonist Protocol
GAN Runxing;LI Yuan;LUO Keli
(Institute of Reproductive &Stem Cell Engineering,Central South University;Reproductive&Genetic Hospital of CITIC-XIANGYA)
Abstract:
Objective: To investigate the effects of controlled ovarian stimulation in PGD/PGS patients who were triggered with gonadotropin-releasing hormone agonist( GnRH-a) and low-dose human chorionic gonadotropin( HCG) to induce oocyte maturation. Methods: We retrospectively analyzed the clinical data in Reproductive&Genetic Hospital CITIC-XIANGYA from January 2015 to March 2016,and all patient with chromosome abnormalities or advanced age underwent IVF/ICSI treatment with gonadotrophin releasing hormone antagonist protocol.79 patients( group A) triggerd with GnRH-a and low-dose HCG were matched for age,AMH and basal FSH with 79 control patients( group B) triggerd with HCG.Stimulation characteristics and the occurrence of hyperstimulation syndrome( OHSS) were compared between the two groups. Results: No differences were observed between the two groups in the age,BMI,b FSH,b LH,AMH,number of antral follicles,numble of 2 PN,and number of Day3 embryos( P>0. 05).Patients in group A had significantly higer number of mature oocytes retrieved,blastulas formed,Day3 top quality embryostop quality blastulasand rate of top quality blastulas than those in group B( P<0. 05).There was no significant difference on the number of normal embryos,although there was increasing trend in group A( P >0. 05).There was no difference on the rate of OHSS between the two groups( P>0. 05).Conclusions: Co-administration of GnRH-agonist and low-dose HCG for final oocyte maturation improves the outcome of controlled ovarian stimulation in PGD/PGS patients.
Key words:  Gonadotropinreleasinghormoneantagonist  Gonadotropinreleasinghormoneangonist  humanchorionicgonadotropin  PGD/PGS

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