中文摘要：

目的评价3种不同促排卵方案在高龄不孕妇女的应用效果，为高龄不孕妇女寻找一种比较经济、有效的超促排卵方案。方法回顾性分析2012年1月2013年12月在新疆医科大学第一附属医院生殖中心行助孕治疗且年龄≥40岁患者共计173个助孕周期的临床资料，按照促排卵方案不同分为：A组（长方案，49个周期）、B组（拮抗剂方案，81个周期）和c组（微刺激方案，43个周期），比较3组病例一般临床资料及助孕结局。结果一般资料方面，3组不孕时间、基础E2、基础LH均无统计学差异，C组平均年龄略高于A、B组，但组间无统计学差异，C组基础FSH高于B组，B组高于A组，3组间有统计学差异。临床结局方面：A组平均Gn时间、平均Gn量及平均每胚Gn量明显高于B组，B组明显高于C组，3组间均有统计学差异；C组平均每卵Gn量最低，与A组、B组间均有统计学差异，A组略低于B组，两者间无统计学差异；C组平均每卯可移植胚胎率略高于B组，组间无统计学差异，A组明显低于B组、C组，组间有统计学差异，C组周期取消率明显高于A、B组，组间有统计学差异，B组略高于A组，组间无统计学差异，3组间临床妊娠率无明显统计学差异。结论在高龄不孕妇女助孕治疗周期中，相对于长方案促排卵费时、费力及微刺激方案高周期取消率，拮抗剂方案促排卵既经济有效又能保持较低周期取消率及较高妊娠率，值得推广应用。

英文摘要：

Objective To evaluate the clinical effect of three different ovarian hyperstimulation programs, and to find out a more economical and effective ovarian hyperstimulation program older infertile women. Methods The records of 173 patients with age of 40 and older who received IVF treatment for infertility from January 2012 to December 2013 were collected. And then they were divided into group A （Long program group, 49 cycles）, group B （antagonist program group, 81 cycles） and group C（micro--stimulation program group, 43 cycles） according to different ovarian hyperstimulation programs. We compared and analyzed the clinical data and outcomes. Results Three groups were not statistically different in duration of infertility and the level of basic t;2 and LH and average age which is slightly higher in group C than group A and group B. But there were statistically differences in the level of basic FSH which was significantly higher in group C than that in group B, and the level of basic FSH in group B was significantly higher than that in group A. The differences also existed in Gn time. The amount of Gn and amount of Gn per embryo were significantly higher in group A than that in group B, and group B was significantly higher than group C. The Gn amount per egg was the lowest in group C which was significantly higher than group A and group B, but the rate of available embryo per egg was slightly higher in Group C than group B, and it was significantly lower in group A than group B, Cycle cancellation rate was highest in group C, but clinical pregnancy rate was no significantly different in three groups. Conclusion During the treatment for older infertile patients, compared with long program which was highest in Gn time and amount, and with micro --stimulation program which has highest cycle cancellation rate, antagonist program maintained a low cycle cancellation rate and a higher pregnancy rate and therefore was both economical and effective, and should be widely applied to clinic practice.