摘要
目的 探究卵巢高反应性不孕症患者应用改良超长拮抗剂方案治疗对其妊娠结局的影响。方法 选取2018年~2021年期间于我院接受治疗的卵巢高反应性(HOR)不孕症患者200例。按治疗方案对所有患者进行分组,应用常规拮抗剂方案的84例病人为对照组,应用改良超长拮抗剂方案的116例病人为观察组。以控制性促排卵资料、血清肿瘤坏死因子(TNF)、血管内皮生长因子(VEGF)及基质金属蛋白酶3(MMP-3)水平、胚胎移植、获卵及受精、中重度卵巢过度刺激综合征(OHSS)发生情况以及妊娠结局为观察指标,评估两种治疗方案。结果 观察组促性腺激素(Gn)使用时间、Gn使用量、人绒毛膜促性腺激素(HCG)日E2水平均较对照组明显下降,移植胚胎数、中重度OHSS发生率、早期流产和异位妊娠例数也呈现相同趋势;而HCG日P/E2、HCG日内膜厚度、移植取消率、种植率、平均取卵数、成熟卵数、成功受精卵数、临床妊娠、正常妊娠例数均较对照组明显升高;同时,与对照组相比,观察组TNF的含量显著升高,而VEGF和MMP-3的含量显著降低,以上数据差异均有显著性(P<0.05)。结论 对于卵巢高反应性不孕症患者,应用改良超长拮抗剂方案进行治疗,可显著改善病人的妊娠结局,对控制性促排卵资料和血清相关因子水平具有一定的正向调节作用,同时,还可改善胚胎移植、获卵及受精情况,降低中重度OHSS发生率,具有较好的应用效果。
Objective To explore the effect of improved ultra-long antagonist therapy on pregnancy outcome in patients with ovarian hyperresponsiveness infertility.Methods We selected 200 patients with ovarian hyperreactivity(HOR)infertility who were treated in our hospital between 2018 and 2021.All the patients were divided into two groups according to the treatment scheme.84 patients with conventional antagonist scheme were used as the control group,and 116 patients with improved ultra-long antagonist scheme were used as the observation group.The data of controlled ovulation induction,serum levels of tumor necrosis factor(TNF),vascular endothelial growth factor(VEGF)and matrix metalloproteinase-3(MMP-3),embryo transfer,oocyte retrieval and fertilization,the occurrence of moderate and severe ovarian hyperstimulation syndrome(OHSS)and pregnancy outcome were used as observation indicators to evaluate the two treatment schemes.Results The usage time and dosage of gonadotropin(Gn)and E2 level of human chorionic gonadotropin(HCG)in the observation group were significantly lower than those in the control group,and the number of transplanted embryos,the incidence of moderate and severe OHSS,the number of early abortion and ectopic pregnancy also showed the same trend.On HCG day,P/E2,intimal thickness,transplant cancellation rate,implantation rate,average number of eggs retrieved,number of mature eggs,number of successful fertilized eggs,clinical pregnancy and normal pregnancy were significantly higher than those in the control group.At the same time,compared with the control group,the content of TNF in the observation group increased significantly,while the content of VEGF and MMP-3 decreased significantly,and the above data were significantly different(P<0.05).Conclusion For the patients with ovarian hyperresponsiveness infertility,the treatment with the improved ultra-long antagonist can significantly improve the pregnancy outcome of the patients,and has a certain positive regulation effect on the data of controlled ovulation induction and the level of serum related factors.At the same time,it can also improve the embryo transfer,egg acquisition and fertilization,and reduce the incidence of moderate and severe OHSS,which has a good application effect.
作者
吴媛媛
何敏
郭沛沛
WU Yuan-yuan;HE Min;GUO Pei-pei(Reproductive Medicine Department of the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan Province,China)
出处
《罕少疾病杂志》
2023年第9期72-74,共3页
Journal of Rare and Uncommon Diseases
基金
河南省医学科技攻关计划项目(LHGJ20210367)。
关键词
卵巢高反应
不孕症
改良超长拮抗剂方案
妊娠结局
Ovarian Hyperresponsiveness
Infertility
Improved Ultra-long Antagonist Scheme
Pregnancy Outcome
