低获卵与体外受精-胚胎移植临床结局的关系  

Relationship between low number of retrieved oocytes and clinical outcomes of in vitro fertilization-embryo transfer

作　　者：王雪梅[1] 姜宏[2] 张文香[2] 魏兆莲[2] 

机构地区：[1]安徽医科大学解放军临床学院生殖医学中心,安徽合肥230031 [2]安徽医科大学第一附属医院生殖医学中心,安徽合肥230032

出　　处：《生殖医学杂志》2012年第6期559-562,共4页Journal of Reproductive Medicine

摘　　要：目的探讨体外受精-胚胎移植(IVF-ET)/卵胞浆内单精子注射(ICSI)过程中获卵数≤5患者的临床结局。方法回顾性分析2008年7月～2011年12月在我院生殖中心行IVF/ICSI获卵数≤5患者的临床资料,共216个移植周期。按年龄分为<35岁组(A组)、35～39岁组(B组)和≥40岁组(C组),选择同期年龄<35岁、获卵数6～15枚的患者共409个移植周期作为A组对照组;将35岁以上高龄低获卵患者按超促排卵方案分为长方案组、短方案组和拮抗剂组,对各组的临床资料及临床结局进行分析。结果 A组与C组的临床妊娠率(38.3%vs.19.4%)及早期流产率(16.1%vs.50.0%)有显著性差异(P<0.05);A组与对照组的临床妊娠率(38.3%vs.41.6%)及早期流产率(16.1%vs.10.0%)间无显著性差异(P>0.05)。不同促排卵方案组间临床妊娠率(29.0%vs.26.1%vs.25.9%)及早期流产率(33.3%vs.33.3%vs.40.0%)间无显著性差异(P>0.05)。结论 IVF/ICSI过程中,<35岁的低获卵患者仍可获得较满意的临床结局;不同超促排卵方案并不能改善高龄低获卵患者的临床结局。Objective： To analyze the clinical outcomes of the infertile women with retrieved oocytes less than or equal to 5 during in vitro fertilization-embryo transfer （IVF-ET） or intracytoplasmic sperm injection （ICSI）. Methods： The clinical data of 216 embryo transfer cycles with retrieved oocytes less than or equal to 5 during the procedure of IV F/ICSI ：in Reproductive Medicine Center of the 105th Hospital of PLA from Jul. 2008 to Dec. 2011 were analyzed retrospectively. All the patients were divided into group A （~ 35 years）, group B （35-39 years） and group C （~40 years） according to the ages. Four hundreds and nine IVF/ICSI cycles with patients＇ age less than 35 years old and 6-15 retrieved oocytes in the same period were served as controlled group. Then the patients ~ 35 years were subdivided into gonadotropin-releasing hormone agonist （GnRH-a） long ：protocol group, GnRH-a short group and GnRH antagonist group according to the protocols of controlled ovarian hyperstimulation（COH）. The clinical date and the outcomes were analyzed and compared among all groups. Results： There were significantly differences in clinical pregnancy rate（38.3% vs. 19.4%） and early abortion rate （16.1% vs. 50.0%） （P^0. 05）, but no significant differences in clinical pregnancy rate （38.3% vs. 41.6%） and early abortion rate （16. 1% vs. 10.0%） between group A and control group （P：〉0.05）. There were no significant differences in clinical pregnancy rates（29. 0% vs. 26. 1~ vs. 25.9%）and early abortion rates（33. 3% vs. 33. 3% vs. 40. 0%）among GnRH-a long protocol group, GnRH-a short group and GnRH antagonist group （P〉0.05）. Conclusions： Relatively satisfactory clinical outcomes of IVF/ICSI would still be obtained for the patients 〈 35 years with retrieved oocytes less than or equal to 5, but whatever controlled ovarian hyperstimulation （COH） protocols such as GnRH-a long protocol, GnRH-a short and GnRH antagonist could not improve the outcomes of IVF/ICS

关 键 词：体外受精-胚胎移植 年龄 超促排卵 获卵数 l临床结局 

分 类 号：R3[医药卫生—基础医学]