目的：探讨超长促排卵方案中基础黄体生成素（basic luteinizing hormone，BLH）水平对排卵正常患者体外受精/卵胞浆内单精子注射（in vitro fertilization or intracytoplasmic sperm injection，IVF/ICSI）治疗结局的影响。方法：回顾性分析本中心2018—2019年就诊306例采用超长促排卵方案的排卵正常患者，按BLH水平不同分为低BLH组（BLH＜5 U/L）158例和高BLH组（BLH≥5 U/L）148例。分别比较两组促性腺激素（gonadotrophic hormone，Gn）用量、平均Gn天数、扳机日血清激素水平、获卵数、优胚数、临床妊娠率等。结果：Gn用量、Gn天数、优势卵泡数、获卵数、成熟卵子数、正常受精数、优质胚胎数均无明显差异（P＞0.05）；获卵率、正常受精率、囊胚形成率两组也无统计学差异（P＞0.05）；但是高BLH组优质胚胎率明显高于低BLH组（P＜0.001）。新鲜胚胎移植结果显示，低BLH组和高BLH组的临床妊娠率无统计学差异（65.3% vs. 64.8%，P＞0.05）；低BLH组的早期流产率（15.6%）明显高于高BLH组（4.4%），差异有统计学意义（P＜0.05）。结论：超长促排卵方案中BLH水平对排卵正常患者IVF/ICSI治疗结局有一定影响，BLH水平偏高者更适合此方案。
Abstract:
Objective：To explore the effects of the basic luteinizing hormone（BLH） level in the super-long protocol on the outcome of IVF/ICSI treatment for patient with normal ovulation. Methods：The clinical data of 306 infertility women undergoning IVF/ICSI and stimulated by super-long protocols in our center from 2018 to 2019 were collected and retrospectively analyzed. According to the level of BLH，they were divided into low BLH group（BLH＜5 U/L，158 cases）and high BLH group（BLH≥5 U/L，148 cases）respectively. The dosage of Gn，the average days of Gn，the serum hormone level on hCG day，the number of oocytes obtained，the number of high-quality embryos and the clinical pregnancy rate were compared between the two groups. Results：There was no significant difference of Gn dosage，Gn days，number of dominant follicles，number of oocytes obtained，number of MII oocytes，number of normal fertilization and number of high-quality embryos（P > 0.05）；there was no significant difference of the rate of oocyte obtained，normal fertilization rate and blastocyst formation rate between the two groups（P > 0.05）；but the rate of high-quality embryos in low BLH group was significantly higher than that in low BLH group（P < 0.001）. The results of fresh embryo transfer showed that the clinical pregnancy rate was no statistical difference（65.3% vs. 64.8%，P > 0.05）；but the early abortion rate of low BLH group（15.6%）was significantly higher than that of low BLH group（4.4%）（P < 0.05）. Conclusion：The BLH of the patients with normal ovulation who was treated super-long protocol has a certain impact on the outcome of IVF/ICSI treatment，and the patients with high LH level is more suitable for this protocol.
