体外受精-胚胎移植周期中不同卵巢反应性与临床结局的分析  

Correlation in ovarian responses and clinical outcome of in vitro fertilization and embryo transfer cycles

作　　者：李玉艳[1] 何畏[1] 俞炽阳[1] 王凤英[1] 龙玲[1] 屈宗银[1] 李红梅[1] 邓丽[1] 

机构地区：[1]第三军医大学西南医院妇产科,重庆400038

出　　处：《第三军医大学学报》2010年第16期1777-1780,共4页Journal of Third Military Medical University

基　　金：重庆市人口计生委科技攻关基金(06-3-01)~~

摘　　要：目的分析常规体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)周期中不同卵巢反应性与临床结局的关系。方法回顾性分析2008-2009年在本生殖中心行常规IVF-ET治疗的414例患者资料,按获卵数不同分为卵巢低反应组(获卵数≤5个,n=79)、正常反应组(6～15个,n=239)及高反应组(≥16个,n=96),对临床结局与获卵数、年龄、用药、激素水平、受精率及优胚率等参数的相关性进行分析。结果低反应组的临床妊娠率(25.3%)明显低于正常反应组(41.4%)及高反应组(43.8%)(P<0.05),而周期取消率(20.0%)明显高于正常反应组(2.9%)和高反应组(5.2%)(P<0.05)。临床结局与年龄、获卵数、ET日内膜厚度及ET优胚数显著相关(r分别为-0.145、0.150、0.141、0.215,P<0.01),卵巢低反应组与其他组间年龄、HCG日的E2、LH、ET日E2、P/E2比值、2PN数、胚胎数、优胚数等差异均有统计学意义(P<0.01,P<0.05)。结论卵巢反应性(获卵数)与临床结局密切相关,而年龄是影响获卵数的重要因素,提高卵巢反应性有助于提高临床妊娠率。Objective To analyze the relationship of the different ovarian response and clinical outcome in in vitro fertilization-embryo transfer （IVF-ET） cycles.Methods A total of 414 cases of IVF-ET during 2008 to 2009 in our department were retrospectively analyzed.Poor responder was defined as ≤5 retrieved oocytes （n=79）,normal responder as retrieved oocytes 5 and ≤15 （n=239）,and high responder as retrieved oocytes 15（n=96）.Correlation of number of retrieved oocytes with clinical outcome,age,medicine,hormone level,fertilization ratio and the good embryo ratio was evaluated.Results Clinical pregnancy ratio in poor responders was significantly lesser than normal responders group and higher responder group （25.3% vs 41.4% and 43.8%,P0.05）.The cancellation cycle ratio in poor responders group was significantly higher than that in the other groups （20.0% vs 2.9% and 5.2%,P0.05）.The clinical outcomes was significantly correlated with ages,endometrium thickness at ET,retrieved oocyte numbers and the number of good embryo for ET （r=-0.145,0.150,0.141,and 0.215 respectively,P0.01）.The retrieved oocyte numbers was significantly correlated with age,E2 and LH at HCG injection day,E2 and P and P/E at ET day （P0.01,P0.05）.Conclusion The ovarian responders （the retrieved oocyte numbers） is tightly related with clinical outcomes,and the age is an important contribution factor on retrieved oocyte numbers.Pregnant rate may be improved by elevating ovarian response.

关 键 词：体外受精-胚胎移植 卵巢反应 获卵数 妊娠结局 年龄 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学] R322.65[医药卫生—基础医学]