0.1 mg GnRHa扳机在拮抗剂方案中对卵母细胞成熟及胚胎结局的影响OA
Ovulation Triggering with 0.1 mg GnRH Agonist in the Effect of Oocyte Maturation and Embryo Outcomes in Antagonist Protocols
目的:比较 0.1 mg 促性腺激素释放激素激动剂(GnRHa)与重组人绒毛膜促性腺激素(rhCG)扳机对拮抗剂方案中卵母细胞成熟及胚胎结局的影响.方法:回顾性分析 2019 年 1 月—2024 年 1 月昆明市妇幼保健院生殖中心行体外受精-胚胎移植采用拮抗剂方案患者的数据,共 1 496 个取卵周期,根据扳机方式的不同分为 A 组(采用 0.1 mg GnRHa 扳机)和 B 组(采用 250 μg rhCG 扳机).使用倾向性评分匹配法(PSM)按 1∶1 的比例匹配两组的基线数据后比较两组患者基线情况、MII 卵率及胚胎实验室结局.结果:PSM 匹配前,A 组纳入 930 个取卵周期,B 组纳入 566 个取卵周期,两组年龄、不孕症类型、抗苗勒管激素水平(AMH)、基础卵泡刺激素水平(bFSH)、基础黄体生成素水平(bLH)、基础雌激素水平(bE2)比较,差异有统计学意义(P<0.05),两组 BMI 比较,差异无统计学意义(P>0.05).PSM 匹配后,两组各纳入 529 个取卵周期,两组年龄、不孕症类型、BMI 比较,差异无统计学意义(P>0.05),而 AMH、bFSH、bLH、bE2 水平比较,差异有统计学意义(P<0.05).A 组相较于 B 组,MII 卵率比较,差异无统计学意义(P>0.05),有更高的双原核受精率(2PN),卵裂期优质胚胎率,差异有统计学意义(P<0.05),差异有统计学意义.结论:拮抗剂方案中,使用 0.1 mg GnRHa 扳机卵母细胞程度与 rhCG 扳机效果一致.高反应人群使用拮抗剂方案,拟行全胚冷冻患者,可考虑采用 0.1 mg GnRHa 扳机.
Objective:To compare the effects of 0.1 mg gonadotropin-releasing hormone agonist(GnRHa)and recombinant human chorionic gonadotropin(rhCG)triggering on oocyte maturation and embryonic outcomes in the antagonist protocol.Method:A retrospective cohort study was conducted to analyze 1 496 oocyte retrieval cycles from patients treated in the Reproductive Center of Kunming Maternal and Child Health Hospital from January 2019 to January 2024.According to different triggering method,they were divided into 2 groups:group A(triggering with 0.1 mg GnRHa)and group B(triggering with 250ug rhCG),who were matched the baseline data using 1∶1 propensity score matching(PSM).After the matching,the two groups of their baseline data,mature metaphase II(MII)oocyte rate,and key laboratory embryonic outcomes were compared between the two groups.Result:Before PSM matching,930 oocyte retrieval cycles were included in group A and 566 oocyte retrieval cycles were included in group B.Age,type of infertility,anti-Mullerian hormone level(AMH),basal follicle-stimulating hormone level(bFSH),basal luteinizing hormone level(bLH),and basal estrogen level(bE2)between the two groups were compared,and the difference was statistically significant(P<0.05),while there was no statistically significant difference in BMI between the two groups(P>0.05).After PSM matching,529 oocyte retrieval cycles were included in each group.There was no statistically significant difference in age,type of infertility,and BMI between the two groups(P>0.05),while there were statistically significant differences in AMH,bFSH,bLH,and bE2 levels(P<0.05).Compared with group B,there was no statistically significant difference in the MII egg rate in group A(P>0.05),but there was a higher double prokaryotic fertilization rate(2PN)and a higher rate of high-quality embryos at the cleavage stage,with statistically significant differences(P<0.05).Conclusion:In the antagonist protocol,0.1 mg GnRHa trigger yields similar MII rates compared to rhCG trigger.0.1 mg GnRHa alone may be considered in high ovarian response patients under antagonist protocol when freeze-all policy is applied.
杨蕴洁;路娜娜;黄荣芳;陈欣欣;姚颖杰;肖彭莹;寸金涛
昆明市妇幼保健院 云南 昆明 650021锦州医科大学昆明市妇幼保健院 云南 昆明 650021昆明市妇幼保健院 云南 昆明 650021昆明市妇幼保健院 云南 昆明 650021昆明市妇幼保健院 云南 昆明 650021昆明市妇幼保健院 云南 昆明 650021
0.1 mg 促性腺激素释放激素激动剂体外受精-胚胎移植拮抗剂方案
0.1mg GnRHa triggerIVF-ETGnRH antagonist protocol
《中外医学研究》 2026 (10)
6-10,5
云南省重大科技专项(202302AA310044)昆明市卫生健康委课题(2023-05-03-001)
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