本文已被:浏览 644次 下载 379次
Received:September 24, 2019 Published Online:July 20, 2020
Received:September 24, 2019 Published Online:July 20, 2020
中文摘要: 目的 探讨卵泡期高孕激素状态下促排卵(PPOS)方案与微刺激方案在卵巢储备功能下降(DOR)患者中行体外受精/卵细胞浆内单精子注射(IVF/ICSI)助孕的有效性与经济性。
方法 回顾性分析2017年8月至2018年2月在中南大学湘雅医院生殖医学中心接受IVF/ICSI治疗的DOR不孕症患者共226个周期,根据促排卵方案不同随机分为A组(PPOS组,n=103)和B组(微刺激组,n=123),比较两组患者的一般资料、临床结局及经济效益。
结果 两组患者的一般资料具有可比性。A组的HCG日黄体生成激素(LH)、孕酮(P)显著低于B组(P均<0.01),HCG日雌二醇(E2)稍低于B组,但差异无统计学意义(P>0.05);A组HCG日优势卵泡数、获卵数、减数分裂Ⅱ期(MⅡ)卵子数、双原核(2PN)胚胎数、可用胚胎数、优质胚胎数多于B组(P<0.05,P<0.01),A组卵泡输出率显著高于B组(P<0.01);卵子利用率、妊娠率及2PN率稍高于B组,但差异无统计学意义(P均>0.05);A组零获卵率显著低于B组(P<0.05),用促性腺激素(Gn)量、Gn天数显著多于B组(P均<0.01);A组无胚胎周期发生率稍低于B组,但差异无统计学意义(P>0.05);A组的成本效果比(总费用/所获卵子或胚胎数)低于B组。
结论 从临床结局来看,PPOS方案较微刺激方案临床疗效好;从经济学分析上看,PPOS方案零获卵率显著低于微刺激方案,PPOS方案的成本效果比低于微刺激方案,提示PPOS方案较微刺激方案经济效益高。
中文关键词: 卵巢储备功能减退 促排卵,高孕激素状态下 微刺激 促排卵结局 成本效果比
Abstract:Objective To investigate the efficacy and economy of progestin-primed ovarian stimulation (PPOS) and micro-stimulation during follicular period in patients of diminished ovarian reserve (DOR) who received fertility treatment of in vitro IVF/ICSI.
Methods A retrospective analysis of 226 cycles of DOR infertility patients who received IVF/ICSI treatment in Xiangya Hospital Central South University from August 2017 to February 2018 was carried out.According to the different ovulation promotion schemes,patients were divided into group A (PPOS group,n=103) and group B (micro-stimulation group,n=123).The general situation,clinical outcome and economic benefit of patients in group A and B were compared.
Results The general conditions of the two groups are comparable.LH and P on HCG day in group A were significantly lower than those in group B (all P<0.05).The E2 on HCG day in group A was slightly lower than that in group B without significant difference (P>0.05).The number of dominant follicles,retrieved oocytes,MII oocytes,2PN embryos,available embryos and high quality embryos on HCG day in group A were significantly higher than those in group B (P<0.05,P<0.01).The egg utilization rate,pregnancy rate and 2PN rate in group A were slightly higher than those in group B,but the difference was not statistically significant (all P>0.05).
The rate of zero oocyte on retrieval in group A was significantly lower than that in group B (P<0.05).The amount and days of using Gn in group A were significantly higher than those in group B (all P<0.05).The rate of non-anembryonic cycle in group A was slightly lower than that of group B without significant difference (P>0.05).The cost-effectiveness ratio of group A was lower than that of group B.
Conclusions From the perspective of clinical outcome,the clinical efficacy of PPOS is better than that of micro-stimulation.From the perspective of economic analysis,the rate of zero oocyte on retrieval of PPOS is significantly lower than that of micro-stimulation,and the cost-effectiveness ratio of PPOS is lower than that of micro-stimulation,suggesting that the economic benefit of PPOS is higher than that of micro-stimulation.
keywords: Diminished ovarian reserve Progestin-primed ovarian stimulation Micro-stimulation Ovulation induction outcome Cost-effectiveness ratio
文章编号: 中图分类号: 文献标志码:A
基金项目:国家自然科学青年基金(81401269)
Author Name | Affiliation |
ZENG Qian-ling,YAN Yi,LI Yan-ping,ZHAO Jing | Reproductive Medicine Center,Xiangya Hospital Central South University,Changsha,Hunan 410000,China |
Author Name | Affiliation |
ZENG Qian-ling,YAN Yi,LI Yan-ping,ZHAO Jing | Reproductive Medicine Center,Xiangya Hospital Central South University,Changsha,Hunan 410000,China |
引用文本: