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目的:探讨高孕激素状态下促排卵方案在临床应用中的价值。方法:将因输卵管因素或男方因素或不明原因行IVF/ICSI治疗的不孕症患者分成高孕激素状态下促排卵组(A组,n=57)和短方案组(B组,n=59),观察患者的获卵数、成熟卵数、正常受精数、卵裂数、有效胚胎数及促排卵过程中血清FSH、LH、E2、P、抑制素A和B的水平及后续冻融胚胎移植(FET)周期的妊娠结局。结果:高孕激素促排卵组患者的获卵数10.8±5.4个,与短方案组相比无统计学差异(P>0.05),获卵数、成熟卵数、受精数、卵裂数,有效胚胎数与短方案组相似(P>0.05),后续的FET周期中,临床妊娠率和胚胎种植率比短方案组稍高(47.9%,42.1%vs 40.9%,31.9%),但均无统计学差异(P>0.05)。高孕激素促排卵过程中LH水平逐渐下降,诱发排卵日的LH水平在1.3±0.9 IU/L,无一例发生自发LH峰。结论:高孕激素状态下促排卵组可以获得具有发育潜能的胚胎,还可以有效控制早发LH峰。高孕激素状态下促排卵方案可作为一种新的促排卵方案应用于临床实践,但是其广泛推广应用还有待多中心的联合研究。
Objective: To investigate the value of ovulation induction in the clinical application of high progesterone. Methods: Infertility patients who underwent IVF / ICSI treatment due to tubal factor or male factor or unknown factor were divided into ovulation induction group (A group, n = 57) and short protocol group (B group, n = 59 ), The number of oocytes retrieved, the number of mature eggs, the number of normal fertilization, the number of cleavage, the number of effective embryos and the levels of serum FSH, LH, E2, P, inhibin A and B and the subsequent freeze-thaw embryo Pregnancy outcome of a transplant (FET) cycle. Results: The number of oocytes retrieved by the high progesterone ovulation group was 10.8 ± 5.4, which was significantly higher than that of the short-term group (P> 0.05). The number of oocytes retrieved, the number of mature oocytes, the number of fertilized eggs, The number of embryos was similar to the short-term group (P> 0.05), but the clinical pregnancy rate and embryo implantation rate were slightly higher than the short-term group (47.9%, 42.1% vs 40.9%, 31.9% Learning difference (P> 0.05). LH progesterone during ovulation induction gradually decreased LH level induced ovulation 1.3 ± 0.9 IU / L, no case of spontaneous LH peak occurred. CONCLUSION: Ovulation with high progestogen status can acquire embryos with developmental potential and can control early LH peak effectively. High progesterone ovarian stimulation program can be used as a new ovulation induction program in clinical practice, but its widespread application has yet to be multi-center joint study.