注射人绒毛膜促性腺激素与否对体外受精周期中改行未成熟卵体外培养结局的影响  

Effect of hCG administration on the outcome of in vitro maturation converted from in vitro fertilization

作　　者：王真[1] 赵军招[1] 王佩玉[1] 金聪聪[1] 林金菊[1] 张巍[1] 叶碧绿[1] 

机构地区：[1]温州医学院附属第一医院生殖中心,温州325000

出　　处：《生殖医学杂志》2011年第4期275-279,共5页Journal of Reproductive Medicine

摘　　要：目的探讨不育患者在常规体外受精-胚胎移植(IVF-ET)周期中改行未成熟卵体外培养(IVM),取卵前注射人绒毛膜促性腺激素(hCG)与否对其实验室及临床结局的影响。方法回顾分析2008年1月至2010年11月在温州医学院附属第一医院生殖医学中心行常规IVF治疗的138个周期,在促排卵5～7d后,双侧卵泡数目≥20个,或用药8～13 d后,卵泡发育缓慢且两侧卵泡数目≥15个,最大卵泡直径平均≤12 mm,根据患者意愿,停药改行IVM治疗,其中63个周期在取卵前12 h注射hCG(A组),75个周期未注射hCG(B组)。比较两组的实验室及临床结局。结果 A组的卵成熟率(64.56%)显著高于B组(56.3%),但是平均获卵数(8.42±0.52)个低于B组(11.32±0.82)个,差异均有统计学意义(P<0.05)。两组的受精率、卵裂率、移植率、临床妊娠率、流产率,多胎妊娠率比较均无统计学差异(P>0.05)。结论常规IVF周期改行IVM后可以获得良好的妊娠结局,取卵前注射hCG虽然可以提高卵子的成熟率,但并不能提高妊娠结局。Objective： To investigate the effectiveness of human chorionic gonadotropin （hCG） administrated before oocytes retrieved on the outcome of in vitro maturation （IVM） converted from conventional IVF （C-IVF） cycles. Methods. We retrospectivly analyzed the data of 138 sterile women who underwent IVM converted from C-IVF cycles in this center from Jan. 2008 to Nov. 2010. The condition of IVM converted from C-IVF was that the developed oocytes were more than 20 after 5-7 days of ovulation induction, or follicular development was retarded and the oocyes were more than 15 after 8-13 days of ovulation induction, and the patientst informed consent was obtained. In 138 cycles, there were 63 cycles with hCG administration 12 hours before oocytes retrieved （group A） and 75 cycles without hCG （group B）. The laboratory test results and pregnancy outcomes were observed and compared. Results. In group A, the rate of maturation （64.56%） was significantly higher than that in group B （56.3%）, but the mean number of oocytes retrieved （8.42±0.52） were significantly lower than that in group B （11.32±0.82） （P〈0.05）. There was no significant difference in rates of fertilization, cleavage, excellent quality embryos, transplantation, clinical pregnancy, multiple pregnancy or transfered cycles between the two groups （P〉0.05）. Conclusions： The program of IVM converted from C-IVF Obtained a satisfactory outcome. The hCG administration before oocytes retrieved enhanced the rate of maturation, but did not improve the pregnancy outcome.

关 键 词：体外受精 未成熟卵母细胞 体外培养 人绒毛膜促性腺激素 

分 类 号：R[医药卫生]