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发育医学电子杂志  2025, Vol. 13 Issue (6): 435-440    DOI: 10.3969/j.issn.2095-5340.2025.06.005
  围产医学   论著 |产科 |
 hCG、GnRH-a及常规黄体支持方案应用于拮抗剂方案的临床研究
王一凡 张皙卉 卢静  黄少鹏
1.邯郸市中心医院 生殖医学科,河北 邯郸 056000; 2. 邯郸市中心医院 泌尿外科,河北 邯郸 056000
Clinical study of hCG, GnRH-a and conventional luteal during support protocols during antagonist protoco
Wang Yifan ZhangXinhui Lujing et al
Department of Reproductive Medicine, Handan Central Hospital, Hebei, Handan 056000, China; 2. Department of Urology, Handan Central Hospital, Hebei, Handan 056000, China)
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摘要 【摘要】目的  对比人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)、促性腺激素释放激素激动剂(gonadotropin-releasing hormone-agonist,GnRH-a)及常规黄体支持方案应用于拮抗剂方案行体外受精/卵胞浆内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)助孕中的效果及妊娠结局,探讨更合适的黄体支持方案。方法 采用回顾性研究方法,选取2018年1月至2019年12月于邯郸市中心医院接受拮抗剂方案行IVF/ICSI-ET助孕的153例患者,依据黄体支持方案的不同将其分为常规黄体支持组(n=49)、hCG黄体支持组(n=50)、GnRH-a黄体支持组(n=54)。常规黄体支持组患者予以常规黄体支持方案,hCG黄体支持组患者在常规黄体支持基础上予以hCG黄体支持方案,GnRH-a黄体支持组患者在常规黄体支持基础上予以GnRH-a黄体支持方案。对比3组患者的临床妊娠率、胚胎种植率、异位妊娠率、流产率、活产率、中重度卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)发生率。统计学方法采用单因素方采用单因素方差分析、χ2  检验。 结果  hCG 黄体支持组、GnRH-a 黄体支持组患者的临床妊娠率均高于常规黄体支持组 [52.00%(26/50)、51.85%(28/54)与 30.61%(15/49),χ2 值分别为 4.666、4.765,P 值均 <0.05] ;hCG黄体支持组、GnRH-a 黄体支持组的活产率均高于常规黄体支持组 [48.00%(24/50)、46.30%(25/54)与24.49%(12/49),χ2 值分别为 5.911、5.307,P 值均 <0.05]。但 hCG 黄体支持组和 GnRH-a 黄体支持组患者的临床妊娠率和活产率比较,差异均无统计学意义(P 值均 >0.05)。3 组的胚胎种植率、异位妊娠率、流产率、中重度 OHSS 发生率比较,差异均无统计学意义(P 值均 >0.05)。 结论  hCG、GnRH-a 黄体支持方案应用于拮抗剂方案行 IVF/ICSI-ET 助孕的效果相当,较常规黄体支持方案可提升临床妊娠率和活产率。

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王一凡 张皙卉 卢静 黄少鹏
关键词:  体外受精 / 卵胞浆内单精子注射 - 胚胎移植  拮抗剂方案  黄体支持  人绒毛膜促性腺激素  促性腺激素释放激素激动剂  妊娠结局    
Abstract: 【Abstract 】 Objective   To compare the e?ects and pregnancy outcomes of human chorionic gonadotropin (hCG), gonadotropin-releasing hormone-agonist (GnRH-a) and conventional luteal support protocol during antagonist protocol for in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI- ET) assisted pregnancy, and to explore the more suitable luteal support protocol.    Method    A retrospective study was conducted. A total of 153 patients who underwent IVF/ICSI-ET assisted pregnancy with theantagonist protocol at Handan Central Hospital from January 2018 to December 2019 were selected. The patients were divided into  the conventional luteal support group (n=49), the hCG luteal support group (n=50) and the GnRH-a luteal support group (n=54). Patients in the conventional luteal support group were given the conventional luteal support protocol, patients in the hCG luteal support group were given the hCG luteal support protocol on the basis of conventional luteal support, patients in the GnRH-a luteal support group were given the GnRH-a luteal support protocol on the basis of conventional luteal support. The clinical pregnancy rates, embryo implantation rates, ectopic pregnancy rates, abortion rates, live birth rates and incidence of moderate to severe ovarian hyperstimulation syndrome (OHSS) were compared among the three groups. Statistical analysis were performed by one-way analysis of variance (ANOVA) and χ2  test.    ResultThe clinical pregnancy rates in the hCG luteal support group and the GnRH-a luteal support group were signi?cantly higher than that in the conventional luteal support group [52.00% (26/50), 51.85% (28/54) vs 30.61% (15/49), with χ2  values of 4.666 and 4.765, respectively, all P<0.05]. Similarly, the live birth rates in the hCG luteal support group and GnRH-a luteal support group were also signi?cantly higher than that in the conventional luteal support group [48.00% (24/50), 46.30% (25/54) vs 24.49% (12/49), with χ2  values of 5.911 and 5.307, respectively, all P<0.05]. However, there was no statistically significant difference in the clinical pregnancy rates and live birth rates between the hCG luteal support group and GnRH-a luteal support group (P>0.05). There were no statistically signi?cant di?erences in the embryo implantation rates, ectopic pregnancy rates, abortion rates and the incidence of moderate to severe OHSS among the three groups (P>0.05).    Conclusion    The e?ect ofthe hCG and GnRH-a luteal support protocol applied to the antagonist protocol for IVF/ICSI-ET assisted pregnancy is comparable. Compared with the conventional luteal support protocol, it can increase the clinical pregnancy rates and live birth rates.

Key words:  In vitro fertilization/intracytoplasmic sperm injection-embryo transfer    Antagonist protocol    Luteal support    Human chorionic gonadotropin    Gonadotropin-releasing hormone-agonist    Pregnancy outcomes
收稿日期:  2024-09-07                     发布日期:  2025-11-30     
基金资助: 河北省 2023 年度医学科学研究课题(20230245)
通讯作者:  黄少鹏    E-mail:  18232154063@163.com)
引用本文:    
王一凡 张皙卉 卢静 黄少鹏.  hCG、GnRH-a及常规黄体支持方案应用于拮抗剂方案的临床研究[J]. 发育医学电子杂志, 2025, 13(6): 435-440.
Wang Yifan ZhangXinhui Lujing et al. Clinical study of hCG, GnRH-a and conventional luteal during support protocols during antagonist protoco. Journal of Developmental Medicine(Electronic Version), 2025, 13(6): 435-440.
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