| Objective: Compare and analysis the effect of GnRH-a long protocol and ultra-short protocol in IVF-ET.Methods: Retrospectively analysis 193 female patients who accepted IVF-ET for gametes transporting barriers during June 1, 2006 to May 31, 2008 at the Reproductive Medical Center of The Second People's Hospital of Nanning which is the Third Affiliated Hospital of Guangxi Medical University. The range of the patients` ages was 25～35 years old , and they accepted 208 COH cycles in all. According to the different treatment options, they were divided into 2 groups, one was group A (GnRH-a long protocol group) with 103 cycles, the other was group B (GnRH-a ultra-short protocol) with 105 cycles. Patients of A group were given GnRH-a (Triptorelin3.75mg/amp) 1.2mg during the mid-luteal of the last menstrual cycle before the use of gonadotropin (Gn), to be completely down-regulated before the use of Gn. The patients of Group B were given (triptorelin 0.1mg/amp) 0.1mg/d for 4 days from the second day of the menstruation, and given Gn from the third day of the menstrual. According to the follicles growth measured with the B-ultrsound monitor, adjusted the amount of Gn, when one follicle-led had an diameter≥18mm or two≥17mm or 3≥16mm, gave patients HCG (Profasi, Merck Serono) 10000u injection at 10 p.m. of that day. HCG Injection 34～36 hours later, eggs mining was operated, then 72 hours after oocytes retrieving embryos were transplanted. And both groups of patients were given luteal support from the day of egg retrieving.Results:1. The number of days of group A and group B for Gn using were (11.60±1.96VS9.62±2.25), the amount of Gn total were (27.32±8.65VS23.75±7.60), the EMT of dayHCG were (11.56±2.38mmVS10.49±2.11mm ) ,and the statistical differences were significant (P <0.05), but there were no significant differences in the levels of E2 LH and P which were measured in the morning of dayHCG (P> 0.05).2. Compared group A with group B , there were no statistical significances in the differences of the amounts of oocytes retrieved, mature eggs, fertilized egg (P> 0.05),but there was statistical significance in differences of the amount of excellent embryos(5.58±2.71VS4.53±3.11)(P <0.05), while there were no statistical significances in the rates of mature oocytes, fertilization and cleavage(P> 0.05), but the differences of the rates of excellent embryo (57.01% ±21.66% VS49.70%±25.61 %) were statistically significant (P <0.05).3. When both group A and group B were transplanted 2 excellent embryos, there were statistically significant differences in the implantation rate (31.00%VS18.39%) and pregnancy rates (49.45% VS30.49%) (P <0.05). 4. Comapared group A and group B, there were no statistically significant differences in the abortion rate (11.54%VS25.00%) and the OHSS rate (2.91%VS6.67%) (P> 0.05).Conclusion:1. Long protocol needs more time and more amount of Gn for the oocyte -maturity than ultra-short protocol in IVF-ET.2. Long protocol can obtain more high-quality embryos than ultra-short protocol in IVF-ET.3. Long protocol maybe could obtain better endometrial receptivity than ultra-short protocol in IVF-ET.4. Long protocol can bring a higher implantation rate and pregnancy rate than ultra-short protocol in IVF-ET, while there will be no differences in the abortion rate and the OHSS rate.
|
PDF Full Text Request