79例低促性腺激素性腺功能减退患者体外受精-胚胎移植结局分析

doi:10.6040/j.issn.1671-7554.0.2019.810

摘要/Abstract

摘要： 目的分析低促性腺激素性腺功能减退(HH)患者体外受精-胚胎移植(IVF-ET)临床结局。方法回顾性分析2013年3月至2017年1月于山东大学附属生殖医院接受第1周期IVF-ET治疗的HH患者79例(HH组),采用同期年龄和BMI匹配、卵巢功能正常、因输卵管因素行IVF-ET的270例患者作为对照(Con组),分析HH患者助孕结局。结果 HH组的临床妊娠率、活产率、冻胚移植活产率和累计妊娠率均不低于Con组。新鲜胚胎移植早期流产率(8.82% vs 10.66%)、宫外孕率(0% vs 1.40%)和冻胚移植早期流产率(0% vs 6.98%)均低于Con组,但因实际发生数目较少,未显示出统计学差异。HH组的促性腺激素(Gn)用药总量［(4 163.61±1 798.98)IU vs (1 872.55±759.19)IU, P<0.001］及用药时间［(14.28±2.80)d vs (11.11±1.90)d, P<0.001］因垂体功能低下较对照组明显增加,调整Gn用药天数、Gn用药总量、HCG日血清LH等因素后(Logistic回归分析),统计结果不受影响。结论因垂体功能异常引起的HH患者,接受IVF-ET/FET治疗可以获得较好的活产率及累计妊娠率,临床结局乐观,不亚于年轻、卵巢功能良好的助孕患者。

关键词: 低促性腺激素性腺功能减退, 体外受精-胚胎移植, 累计妊娠率

Abstract: Objective To evaluate the outcomes of in vitro fertilization and embryo transfer(IVF-ET)in women with hypogonadotropic hypogonadism(HH). Methods The retrospective study involved 79 women with HH(HH group)who received first cycle IVF-ET during Mar. 2013 and Jan. 2017 in Center for Reproductive Medicline, Shandoug University, and 270 controls(control group)with matched age, body mass index(BMI), and normal ovarian reserve who received IVF-ET due to oviduct diseases. The outcomes of IVF-ET were compared between the two groups. Results There were no statistical differences in clinical pregnancy rate, live birth rate of fresh or frozen embryo transfer and cumulative pregnancy rate between the two groups. The early abortion rate of fresh embryo transfer(8.82% vs 10.66%), rate of ectopic pregnancy(0% vs 1.4%)and early abortion rate of frozen embryo transfer(0% vs 6.98%)were lower in HH group than in control group although no statistical significance was obtained due to limited number of samples. The HH group had more dosage of gonadotropin(Gn)［(4 163.61±1 798.98)IU vs(1872.55±759.19)IU, P<0.001］and longer Gn stimulation duration ［(14.28±2.80)d vs(11.11±1.90)d, P<0.001］ than the control group. After we adjusted the total dosage and medication time of Gn, serum HCG and other related factors, we obtained similar results. Conclusion Women with hypophysical dysfunction will get expected high live birth rate and cumulative pregnancy rate 山东大学学报 (医学版)58卷1期 -冯振花,等.79例低促性腺激素性腺功能减退患者体外受精-胚胎移植结局分析 \=-after IVF-ET/FET treatment. Their clinical outcomes are comparable to those of young patients with good ovarian function.

Key words: Hypogonadotropic hypogonadism, In vitro fertilization, Cumulative pregnancy rate

中图分类号:

R711.6

冯振花,李元美,崔文娟,司蕊,盛燕,赵涵. 79例低促性腺激素性腺功能减退患者体外受精-胚胎移植结局分析[J]. 山东大学学报 (医学版), 2020, 58(1): 43-48.

FENG Zhenhua, LI Yuanmei, CUI Wenjuan, SI Rui, SHENG Yan, ZHAO Han. High live birth rate in women with hypogonadotropic hypogonadism after treatment of in vitro fertilization[J]. Journal of Shandong University (Health Sciences), 2020, 58(1): 43-48.

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