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1 33 10 Vol.33 No Oct Reproduction & Contraception doi: /j.issn X ( ) : () GnRH-a - () : IVF- ET 233 A (I~II 102 ) B (III~IV 131 ) : FSH (bfsh) (P>0.05) B A (P< 0.01) (Gn) hcg Gn (P>0.05) (P>0.05) (60.64% vs 62.18%)(P>0.05) : : (); - (); (COS); : R711.6 : A : X(2013) (endometriosis ) - (in vitro fertilization-embryo transfer ) (gonadotropin release hormone agonist GnRH-a) GnRH-a : : ; Tel: ; Fax: ; angelicadeng@aliyun.com ~ IVF : <35 ; ; (bfsh<10 miu/ml be2<50 pg/ml) [1] ; (BMI)=18.0~24.9 kg/m 2 ; ; (25~35 d); (rafs)

2 60 mg/d 10~12 I ( ) II ( ) III ( ) IV ( ) I~II A III~IV B GnRH-a GnRH-a( Diphereline 3.75 mg/ ) 3 2~5 (AFC) 1 GnRH-a ~50 [ <5 mm <5 mm (FSH)<5 miu/ml (LH)<5 miu/ml (E2)<30 pg/ml] (gonadotropin Gn) Gn Gn (r-fsh Gonal-F 75 IU/ ) (hmg 75 IU/ ) B (E2 P LH FSH) 3 18 mm (rhcg )250 μg 35~37 h B IVF/ICSI(intracytoplasmic sperm injection) : 2 4~5 3 7 <20% : 3 4 <50% 72 h B <7 mm (ovarian hyperstimulation syndrome OHSS) OHSS OHSS ( )80 mg/d 60 mg/d 14 d / β-hcg : 14 d β-hcg β-hcg>25 miu/ml [2] 28~35 d B 1.3 SPSS17.0 (x s) t χ 2 P< A 102 B 131 BMI FSH(bFSH) AFC (P>0.05); B ( ) A (P<0.01) 1 1 (x s %) Table 1 Basic characteristics of patients n ( )Age (year) (a) Duration of infertility BMI (kg/m 2 ) Type of infertility Primary Secondary (49/102) (53/102) (66/131) (65/131) (a) Years to last surgery (n) Surgery times bfsh (miu/ml) AFC Basal AFC (n) Previous surgery of ovarian endometrioma Unilateral Bilateral None (35/102) * (12/102) * (55/102) (61/131) (33/131) (37/131) *: P<0.01 B compared with group B 673

3 2.2 A 102 (controlled ovarian stimulation COS) OHSS 2 94 B 131 COS OHSS COS (2.94% vs 3.82%) (P>0.05) 2.3 COS 2 Gn hcg (E2 P LH FSH) (P>0.05) Gn B Gn A (P>0.05) Gn hcg M II M II M II ( ) ( ) (P>0.05) 2.4 ET (P>0.05) (P>0.05) [3] [4] [5] 3.2 [6] ( ) 2 COS (x s %) Table 2 Data of COS cycles n Gn Gn launch day E2 (pg/ml) P (ng/ml) LH (miu/ml) FSH (miu/ml) hcg hcg injection day E2 (pg/ml) P (ng/ml) LH (miu/ml) FSH (miu/ml) (mm) Endometrial thickness Gn (IU) Doses of Gn on launch day Gn (IU) Total doses of Gn used Gn (d) Days of Gn used (n) No. of follicles (n) No. of oocytes retrieved MII (n) No. of MII oocyte number MII MII oocyte rate MII (623/777) (771/940) (534/623) (670/771) Fertilization rate of MII oocytes Cleavage rate (520/534) (645/670) (n) No. of transferable embryos (329/520) (430/645) Transferable embryo rate (113/520) (153/645) Good-quality embryo rate (n) No. of good-quality embryos Coccia [6] I~II IVF I~II III~IV 674

4 3 (x s %) Table 3 Clinical outcomes of embryo transfer (ET) cycles of patients ET (n) ET cycle number (n) No. of embryos transferred Implantation rate Clinical pregnancy rate Abortion rate Ectopic pregnancy rate (82/176) (62/94) 6.45 (4/62) 1.61 (1/62) (57/94) (117/237) (82/119) 8.54 (7/82) 1.22 (1/82) (74/119) Live birth rate per ET cycle IVF [11] [1213] [14] : [15] / AFC (P>0.05) [16] hcg E2 III~IV 3.3 GnRH-a GnRH-a FSH LH GnRH GnRH-a GnRH-a LH [7] IVF 2~3 GnRH-a GnRH-a ART [8] [9] 3.4 [10] [17] B (III~IV ) ( ) IVF B COS Gn hcg Gn B Gn A Gn hcg M II / M II / / ET 675

5 ( ) ART [1]... : 2012:109. [2] (10): [3] Christodoulakos G Augoulea A Lambrinoudako I et al. Pathogenesis of endometriosis: the role of defective immunosurveillance. Eur J Contracep Reprod Health Care (3): [4] Kalu E Sumar N Giannopoulos T et al. Cytokine P profiles in serum and peritoneal fluid from infertile women with and without endometriosis. J Obstet Gynaecol Res (4): [5] Minici F Tiberi F Tropea A et al. Endometriosis and human infertility: a new investigation into the role of eutopic endometrium. Hum Reprod (3): [6] Coccia ME Rizzello F Mariani G et al. Impact of endometriosis on in vitro fertilization and embryo transfer cycles in young women: a stage-dependent interference. ACTA Obstet Gynecol (11): [7] Ma C Qiao J Liu P et al. Ovarian suppression treatment prior to in-vitro fertilization and embryo transfer in Chinese women with stage or endometriosis. Int J Gynaecol Obstet (2): [8] (3): [9]. GnRH-a (4): [10] Suzuki T Izumi S Matsubayashi H et al. Impact of ovarian emdometrioma on oocytes and pregnancy outcome in in vitro fertilization. Fertil Steril (4): [11] Exacoustos C Zupi E Amadio A et al. Laparoscopic removal of endometriomas: sonographic evaluation of residual functioning ovarion tissue. Am J Obstet Gynecol (1): [12] Alborzi S Ravanbakhsh R Parsanezhad ME et al. A comparison of follicular response of ovaries to ovulation induction after laparoscopic ovarian cystectomy or fenestration and coagulation versus normal ovaries in patients with emdometrioma. Fertil Steril (2): [13] (1):60-2. [14] Busacca M Riparin J Somigliana E et al. Postsurgical ovarian failure after laparoscopic excision of bilateral endometromas. Am J Obstet Gynecol (2): [15]. ART (9): [16] Carcia-Velasco JA Mahutte NG Corona J et al. Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched case-control study. Fertil Steril (5): [17] Esinler I Bozdag G Aybar F et al. Outcome of in virto fertilization/intracyto plasmic sperm injection after laparoscopic cystectomy for endometriomas. Fertil Steril (6): ( ) ( 695 refer to p695) ****************************************************************************************************************************************** : 779 : : : : : randc_journal@163.com 676

IVF (,, ) : (HP-hMG) - (IVF- ET) : GnRH, HP-hMG (HP-hMG )57, (rfsh )140, (Gn)

IVF (,, ) : (HP-hMG) - (IVF- ET) : GnRH, HP-hMG (HP-hMG )57, (rfsh )140, (Gn) 34 11 Vol.34 No.11 2014 11 Nov. 2014 Reproduction & Contraception doi: 10.7669/j.issn.0253-3X.2014.11.0892 E-mail: randc_journal@163.com IVF ( 710003) : (H-hMG) - (IVF- ET) : GnRH H-hMG (H-hMG ) (rfsh

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