小剂量生长激素对高龄且预期卵巢反应正常患者体外受精-胚胎移植助孕效果的研究OA
Study on the effect of low-dose growth hormone on pregnancy outcomes of IVF-ET in elderly patients with expected normal ovarian response
目的 探讨小剂量生长激素(GH)的应用对高龄且预期卵巢反应正常患者体外受精-胚胎移植(IVF-ET)助孕结局的影响.方法 选取2022年7月至2023年12月于我院生殖医学中心行IVF-ET助孕的230例35～43岁且预期卵巢反应正常患者作为研究对象,共230个促排卵周期.采用随机数字表法将患者随机分为干预组(n=115)和对照组(n=115).干预组采用促性腺激素释放激素激动剂(GnRH-a)黄体期长方案促排卵,降调节启动日起加用GH 2 U/d,持续治疗至扳机日;对照组不使用GH预处理.比较两组患者的基本资料、促排卵情况、胚胎发育情况、临床妊娠结局及卵泡液中雌二醇(E2)、孕酮(P)水平.结果 两组患者的基本资料比较均无统计学差异(P＞0.05).干预组促性腺激素(Gn)天数、扳机日血清P水平及取卵日卵泡液P水平均显著低于对照组(P＜0.05),可利用胚胎率显著高于对照组(P＜0.05).两组患者间Gn总量、扳机日血清E2水平、获卵数、双原核(2PN)受精率、D3优质胚胎率、鲜胚移植周期种植率、临床妊娠率、早期流产率、活产率以及累计活产率、取卵日卵泡液E2水平比较均无统计学差异(P＞0.05).结论 小剂量GH用于高龄且预期卵巢反应正常的IVF-ET患者,可改善卵巢反应性并增加可利用胚胎率,但对妊娠结局无显著影响.
Objectives:To explore the effect of low-dose growth hormone(GH)application on the pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET)among elderly patients with expected normal ovarian response. Methods:A total of 230 patients aged 35 to 43 years with expected normal ovarian response who underwent IVF-ET(230 cycles in total)at the Department of Reproductive Center of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from July 2022 to December 2023 were selected as the research subjects.The patients were randomly divided into the intervention group(n=115)and the control group(n=115)using a random number table.The intervention group was treated with a long luteal phase protocol of gonadotropin-releasing hormone agonist(GnRH-a)for ovulation induction,and 2 U/d of GH was added from the start of down-regulation until the trigger day.Patients in the control group did not receive GH pretreatment.The basic data,ovulation induction conditions,embryo development,clinical pregnancy outcomes,and levels of estradiol(E2)and progesterone(P)in follicular fluid of the two groups were compared. Results:There were no statistically significant differences in the basic data between the two groups(P＞0.05).The intervention group had significantly lower gonadotropin(Gn)days,serum P levels on the trigger day,and P levels in follicular fluid on the oocyte retrieval day(P＜0.05),and a significantly higher rate of available embryos than the control group(P＜0.05).There were no statistically significant differences in total dosage of Gn use,serum E2 levels on the trigger day,number of retrieved oocytes,two pronuclei(2PN)fertilization rate,D3 high-quality embryo rate,pregnancy outcome indicators of fresh transfer cycle(embryo implantation rate,clinical pregnancy rate,early miscarriage rate,live birth rate),cumulative live birth rate,and E2 levels in follicular fluid on the oocyte retrieval day between the two groups(P＞0.05). Conclusions:Low-dose GH application in elderly IVF-ET patients with expected normal ovarian response can improve ovarian response and increase the rate of available embryos,but has no significant effect on pregnancy outcomes.
甘冬英;周红;蔡君英;赖梦云;邓曦和
广西壮族自治区妇幼保健院生殖医学中心,南宁 530003广西壮族自治区妇幼保健院生殖医学中心,南宁 530003广西壮族自治区妇幼保健院生殖医学中心,南宁 530003广西壮族自治区妇幼保健院生殖医学中心,南宁 530003广西壮族自治区妇幼保健院生殖医学中心,南宁 530003
医药卫生
体外受精高龄卵巢正常反应生长激素活产率
In vitro fertilizationElderlyNormal ovarian responseGrowth hormoneLive birth rate
《生殖医学杂志》 2026 (5)
611-616,6
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210227)
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