| 240 | 7 | 12 |
| 下载次数 | 被引频次 | 阅读次数 |
目的探讨比较拮抗剂方案与微刺激方案应用于卵巢储备功能低下的高龄不孕患者的临床疗效及费效比。方法回顾性分析2015年10月-2017年10月就诊于乌海市卫生与计划生育委员生殖中心接受体外受精/卵细胞内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的周期患者60例,年龄≥35岁,依据不同的控制性促排卵方案将患者分为拮抗剂方案组(1组,30例)及微刺激方案组(2组,30例),比较这两种方案的临床疗效和费效比。结果 (1)1组累积临床妊娠率和累积活产率方面均高于2组,差异有统计学意义(P<0.05);(2)每获1枚成熟卵子所需费用、每获1枚优胚所需费用及每获1个活产所需费用1组均低于2组,差异有统计学意义(P<0.05)。结论综合分析,在高龄卵巢储备功能低下不孕患者中,无论从临床疗效及卫生经济学方面比较,拮抗剂方案均是比较理想的选择。
Abstract：Objective To compare the clinical effect and cost-effectiveness of antagonist and microstimulation protocol among elderly infertile patients with low ovarian reserve function. Methods A Retrospective analysis of 60 patients aged over 35 years old who received in vitro fertilization( IVF)/intracytoplasmic sperm injection( ICSI)-embryo transfer( ET) was conducted at the Reproductive Center of Yinchuan Maternal and Child Health-Care Center from October 2015 to October 2017. According to different controlled ovulation promotion protocol,thepatients were divided into antagonist group( first group,30 cases) and microstimulation group( second group,30 cases). The clinical effect and cost-effectiveness ratio of the two groups were compared. Results(1)Both the cumulative clinical pregnancy rate and cumulative live rate in the first group were higher than those in the second group. There was a statistical difference between the two groups( P < 0. 05).(2)The cost of getting each mature egg,one quality embryo and one live birth in the first group were less than those in the second group. There was a statistical difference between the two groups( P < 0. 05).Conclusion Comprehensive analysis showed that the antagonist regimen was an ideal choice in elderly infertility patients with low ovarian reserve function both in terms of clinical effect and health economics.
[1]Rose BI,Laky DC,Rose SD.A comparison of the use of clomiphene citrate and letrozole in patients undergoing IVF with theobjective of producing only one or two embryos[J].Facts Views Vis Obgyn,2015,7(2):119-126.
[2]Yoo JH,Cha SH,Park CW,et al.Comparison of mild ovarian stimulation with conventional ovarian stimulation inpoor responders[J].Clin Exp Reprod Med,2011,38(3):159-163.
[3]Orvieto R,Nahum R,Meltzer S,et al.GnRH agonist versus GnRH antagonist in ovarian stimulation:the role of elevated peak serum progesterone levels[J].Gynecol Endocrinol,2013,29(9):843-845.
[4]Luna M,Vela G,Mcdonald CA,et al.Results with GnRH antagonist protocols are equivalent to GnRH agonist protocols in comparable patient populations[J].J Reprod Med,2012,57(3/4):123-125.
[5]Siristatidis C,Trivella M,Chrelias C,et a1.A short narrative review of the feasibility of adopting mild ovarian stimulation for IVF as the current standard of care[J].Arch Gynecol Obstet,2012,286:505-510.
[6]Simon,Paesde Almeida Ferreira Braga D,Biaggioni Lopes F,et al.The effect of GnRH analogues for pituitary suppression on ovarian response in repeated ovarian stimulation cycles[J].Arch Med Sci,2011,7(3):470-475.
[7]Ching-Chien,Chang,Ph D,et al.Prospective controlled study to evaluate laboratory and clinical outcomes of oocyte vitrification obtained in in vitro fertilization patients aged 30 to 39 years[J].Fertility and Sterility,2013,99(7):1891-1897.
[8]Abe T,Fukuda J,Okuno T,et a1.Cumulative pregnancy rates after minimal ovarian stimulation for in vitro fertilization[J].Fertil Steril,2013,100(Suppl 1):S271.
[9]Choi MH,Cha SH,Park CW,et al.The effectiveness of earlieroocyte retrieval in the case of a premature luteinizing hormonesurge on h CG day inin vitrofertilizationembryo transfer cycles[J].Clin Exp Reprod Med,2013,40(2):90-94.DOI:10.5653/cerm.2013.40.2.90.
[10]Kuang Y,Hong Q,Chen Q,et al.Luteal-phase ovarian stimulationis feasible for producing competent oocytes in women undergoing invitro fertilization/intracytoplasmic sperm injection treatment,withoptimal pregnancy outcomes in frozen-thawed embryo transfer cycles[J].Fertil Steril,2014,101(1):105-111.
基本信息:
DOI：10.19757/j.cnki.issn1674-7763.2018.03.019
中图分类号:R714.8
引用信息:
[1]魏秀英,王春珺,张燕.拮抗剂方案与微刺激方案在卵巢储备功能低下的高龄患者中的临床结局及费效比比较[J].中国妇幼卫生杂志,2018,9(03):63-65+69.DOI:10.19757/j.cnki.issn1674-7763.2018.03.019.
基金信息: