Page 60 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第2期
·206 · Journal of Nanjing Medical University（Natural Sciences） 2022年2月

·临床医学·

两种长效GnRH⁃a在降调节方案冻融胚胎移植周期准备内膜的

临床疗效比较

张 娟，周羽西，张娟娟，李 欣，张媔秋，苏 雁，凌秀凤，赵 纯 *

南京医科大学附属妇产医院生殖医学中心，江苏 南京 210004

［摘 要］ 目的：比较两种长效促性腺激素释放激素激动剂（gonadotropin⁃releasing hormone agonist，GnRH⁃a）在降调节联合激
素替代周期冻融胚胎移植（frozen embryo transfer，FET）中的临床疗效。方法：回顾性队列研究分析2019年11月1日—2021年1月
31 日期间在南京医科大学附属妇产医院生殖医学中心采用 2 种不同的长效 GnRH⁃a 准备内膜的冻融囊胚移植周期共 462 周
期，其中曲普瑞林组324周期，亮丙瑞林组138周期。通过Logistic回归模型分析2种长效GnRH⁃a与FET临床疗效的关系。结
果：亮丙瑞林组雌激素启动日 LH［（2.70±1.28）mU/ml］高于曲普瑞林组［（2.41±1.19）mU/mL，P=0.017］；亮丙瑞林组种植率
（62.6%）高于曲普瑞林组（54.6%），差异有统计学意义（P=0.044），临床妊娠率相对于曲普瑞林组有升高趋势，但差异无统计学
意义（P=0.334），早期流产率较曲普瑞林组有下降趋势，但差异也无统计学意义（P=0.490）。在Logistic 回归模型中，校正包括
年龄、移植囊胚数、优质囊胚数、雌激素启动日LH水平、内膜厚度在内的混杂因素后，亮丙瑞林组相对于曲普瑞林组临床妊娠
率的校正OR值为1.493（95%CI=0.932~2.392，P=0.095）。结论：在降调节激素替代FET中，亮丙瑞林和曲普瑞林均可达到满意
的降调效果，亮丙瑞林可提高囊胚的种植率，并获得与曲普瑞林相似的临床结局。
［关键词］ 亮丙瑞林；曲普瑞林；降调节联合激素替代周期；冻融胚胎移植；临床结局
［中图分类号］ R711.6 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）02⁃206⁃05
doi：10.7655/NYDXBNS20220210

Comparison of clinical efficacy of two long ⁃ acting gonadotropin ⁃ releasing hormone
agonists in down⁃regulation combined with hormone replacement cycle of frozen⁃thawed

embryo transfer
ZHANG Juan，ZHOU Yuxi，ZHANG Juanjuan，LI Xin，ZHANG Mianqiu，SU Yan，LING Xiufeng，ZHAO Chun *
Center of Reproductive Medicine，the Affiliated Obstetrics and Gynaecology Hospital of Nanjing Medical University，
Nanjing 210004，China

［Abstract］ Objective：This study aims to compare the clinical efficacy of two long⁃acting gonadotropin⁃releasing hormone agonists
（GnRH ⁃ a）in down ⁃ regulation combined with hormone replacement cycle frozen ⁃ thawed embryo transfer（FET）. Methods：A
retrospective cohort study of 462 frozen⁃thawed blastocyst transfer cycles using two different long⁃acting GnRH⁃a for endometrial
preparation was performed at the Department of Reproductive Medicine，the Affiliated Obstetrics and Gynaecology Hospital of Nanjing
Medical University from November 1，2019 to January 31，2021，including 324 cycles in the triptorelin group and 138 cycles in the
leuprorelin group. Logistic regression model was used to analyze the relationship between two long⁃acting GnRH⁃a and the clinical
efficacy of frozen⁃thawed blastocyst transfer. Results：The level of LH［（2.70±1.28）mU/mL］on estrogen initiation day was higher than
that in triptorelin group［（2.41±1.19）mU/ mL］，P=0.017］；The implantation rate of leuprorelin group（62.6%）was higher than that of
triptorelin group（54.6%），and the difference was statistically significant（P=0.044）；the clinical pregnancy rate was increased
compared with the triptorelin group，but the difference was not statistically significant（P=0.334），and the early abortion rate was
decreased compared with the triptorelin group，but the difference was not statistically significant（P=0.490）. In the logistic regression
model，after adjusting for confounding factors including age，number of blastocyst，number of good⁃quality blastocyst，the level of LH on

［基金项目］ 国家自然科学基金（81971386）
∗
通信作者（Corresponding author），E⁃mail：zhaochun2008@yeah.net