王彬++++++梁见弟++++++彭宇洪++++++陈惠南++++++刘志刚++++++莫玉琴

[摘要]目的 研究不同卵巢刺激方案在卵巢储备功能下降妇女中的应用效果。方法 选择我院2015年6月～2016年5月收治的56例卵巢储备功能下降的女性患者为观察对象，根据卵巢刺激方案分为两组，黄体晚期开始进行卵巢刺激的28例患者设为观察组，黄体中期进行短效长方案刺激的28例女性患者设为对照组。对比两组患者的子宫内膜厚度、HCG日E2水平、获卵个数、优质胚胎数量等。结果 观察组达菲林使用天数为（10.15±0.37）d，HCG日E2水平为（1734.12±165.61）pg/ml，获卵个数为（8.30±1.17）个，优质胚胎数量为（4.60±0.82）个，明显优于对照组的（25.45±1.65）d、（1308.87±143.30）pg/ml、（7.20±0.76）个、（2.60±0.50）個（P<0.05）；两组HCG日LH水平、HCG日P水平、子宫内膜厚度及Gn总量比较，差异无统计学意义（P>0.05）。结论 黄体晚期开始予以卵巢刺激能够提高患者的获卵数、可用胚胎数、优质胚胎数，可缩短达菲林使用时间并降低治疗费用。

[关键词]卵巢储备功能；黄体期；促排卵

[中图分类号] R711.6 [文献标识码] A [文章编号] 1674-4721（2017）07（a）-0119-03

Effect of application of different ovarian stimulation protocols on women with decreased ovarian reserve functions

WANG Bin LIANG Jian-di PENG Yu-hong CHEN Hui-nan LIU Zhi-gang MO Yu-qin

Department of Reproductive Medicine，Dongguan People′s Hospital，Guangdong Province，Dongguan 523000，China

[Abstract]Objective To study the effect of application of different ovarian stimulation protocols in women with decreased ovarian reserve functions.Methods Altogether 56 cases of female patients with decreased ovarian reserve functions who were treated in our hospital from June 2015 to May 2016 were selected as the study object and divided into two groups according to the ovarian stimulation protocols；28 patients who underwent ovarian stimulation in the late luteal phase were involved as observation group；while，another 28 patients who underwent short-acting long protocol stimulation were involved as control group.The endometrial thickness，E2 level at the day of HCG administration，number of oocytes and the number of high-quality embryos were compared between the two groups.Results The Diphereline usage days，E2 level at the day of HCG administration，the number of oocytes and the number of high-quality embryos of observation group were （10.15±0.37） d，（1734.12±165.61） pg/ml，（8.30±1.17） eggs and （4.60±0.82） embryos，significantly better than those of control group [（25.45±1.65） d，（1308.87±143.30） pg/ml，（7.20±0.76） eggs and （2.60±0.50） embryos]（P<0.05）.There was no statistically significant difference in the LH and P level at the day of HCG administration，endometrial thickness and total Gn between two groups （P>0.05）.Conclusion Application ovarian stimulation at the late stage of luteal phase can improve the number of obtained oocytes，available embryos and high-quality embryos，which can shorten the Diphereline usage days and reduces the cost of treatment.

[Key words]Ovarian reserve functions；Luteal phase；Ovulation induction

近年来，体外受精-胚胎移植（in vitro fertilization and embryo transfer，IVF-ET）早已成为治疗不孕症的常用方案[1]。有文献报道，卵巢储备功能下降的女性患者约占不孕不育症的10%，而且近年来比例逐渐上升并呈显出年轻化趋势[2]。有效的控制性卵巢刺激已广泛应用于IVF-ET过程，可显著提高患者的治疗效果，但仍有很多卵巢储备功能下降的女性对控制性卵巢刺激方案不敏感，甚至无反应[3]。合理改善卵巢储备功能低下女性的妊娠结局是治疗不孕不育的方法之一。我院通过强化黄体晚期卵泡以期待增加获卵数目，增加可利用胚胎，提高优质胚胎率，从而改善不孕妇女的IVF妊娠率，现报道如下。……