目的 探讨多囊卵巢综合征不孕患者体外受精-胚胎移植(IVF/ICSI)技术辅助生育时不同的降调节方案对于助孕治疗结局的影响。方法 纳入2016年10月～2018年2月在我院生殖中心助孕治疗的70例多囊卵巢综合征(PCOS)不孕女性作为研究对象,根据控制性超促排卵(COS)所应用的降调节方案的不同将患者随机分为两组：长效长方案组(A组)35例,经典长方案组(B组)35例。A组降调节是于早卵泡期注射长效GnRHa,B组降调节是于黄体中期使用短效GnRHa。对比研究两组方案的刺激天数(Gn天数)、以及促性腺激素使用的总剂量(Gn量)、HCG扳机日子宫内膜厚度、激素水平、取卵后的获成熟卵率(MII卵率)、优质胚胎率、移植后的种植率、临床妊娠率及全胚胎冷冻率。结果 (1)两组比较A组的Gn量和优胚率高于B组,HCG扳机日雌二醇、孕酮水平低于B组,差异均有统计学意义(P＜0.05)；(2)两组的Gn天数、HCG扳机日的子宫内膜厚度、获成熟卵率、种植率以及临床妊娠率相比较,差异无统计学意义(P＞0.05)。结论 长效长方案较经典长方案可以达到充分降调节的目的,抑制了黄体生成素(LH)峰在超促排卵前及过程中的出现,可以提高多囊卵巢综合征患者的优胚率、降低HCG扳机日孕酮水平,改善其妊娠结局,可以成为多囊卵巢综合征不孕患者控制性超促排卵的一个理想选择。

【Objective To investigate the pregnancy outcome of the infertile patients with PCOS who underwent two different down-regulation protocol during IVF/ICSI-ET treatment. Method 70 infertile patients with PCOS who acceped IVF/ICSI-ET between Oct. 2016 to Feb. 2018 in our center were enrolled in the study.The patients were divided into long-acting GnRHa agonist long protocol group(grou A) and classical long protocol group(group B) randomly, Group A was given long-acting GnRHa agonist during early follicular phase, Group B was utilized short-acting GnRHa on midluteal phase.We analyzed the Duration of stimulation（days of Gn）、doses of injecting gonadotrophins（doses of Gn）、endometrial thickness and the level of estradiol and progesterone on trigger day、rate of mature eggs、high qualified embryo rate、implantation rate、total embryo freezing rate and clinical pregnancy rate contrastively. Results Group A is higher than group B significantly about the hige grade embryo rate and the dose of Gn（P＜0.05）; the levels of E2、P on the HCG day in group A are significantly lower than those in group B（P＜0.05）; （2）Group A was not significantly different from group B about the endometrial thickness on trigger day、rate of mature ovum、implantation rate、clinical pregnancy rate、and the total embryo freezing rate（P＞0.05）.Conclusion Compared with classical long protocol, long-acting GnRHa agonist long protocol can achieve the aim of inhibiting pituitarium completely,suppress luteinizing hormone(LH) before and during controlled ovrian hyperstimulation（COS）,promote the good quality embryo rate，control the level of P on trgger day. which can improve endometrial receptivity and clinical outcome in the infertile patients with PCOS，and can be an ideal option.

R711.75