OHSS高危患者两种移植方案的临床结局分析  

Outcome analysis on the two embryo transfer policies in high-risk OHSS patients

作　　者：谢鑫[1] 曹云霞[1] 周平[1] 吴欢[1] 张媛媛[1] 刘迎春[1] 

机构地区：[1]安徽医科大学第一附属医院生殖医学中心,合肥230022

出　　处：《安徽医科大学学报》2013年第1期34-37,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省国际合作项目(编号:09080703033)

摘　　要：目的比较研究控制性超促排卵(COH)周期患者移植日前有卵巢过度刺激综合征(OHSS)高危因素时行全胚胎冷冻以及行新鲜周期移植的两种方案的临床结局。方法回顾性分析接受COH治疗且取卵前出现OHSS高危因素的患者267例,随机分为A、B两组。A组:全胚胎冷冻并行首次解冻胚胎移植的122例;B组:行新鲜周期胚胎移植的145例。对两组患者的年龄、不孕年限、不孕因素、身体质量指数(BMI)、COH情况[促性腺激素(Gn)启动剂量、超排天数、Gn总量、注射人绒毛膜促性腺激素(HCG)日内膜、HCG日雌二醇(E2)水平、HCG日卵巢大小]、获卵数、优质胚胎数、重度OHSS发生率、新鲜周期及复苏周期的生化妊娠率、临床妊娠率进行比较分析。结果两组患者年龄、不孕年限、不孕因素、BMI、COH情况、获卵数、优质胚胎数差异无统计学意义。A组患者重度OHSS的发生率(2.46%)显著低于B组(8.28%),差异有统计学意义(P<0.05)。两组的生化妊娠率(50.0%vs 47.6%)、临床妊娠率(36.9%vs33.8%),差异无统计学意义。结论与新鲜周期移植比较,OHSS高危患者行全胚胎冷冻后复苏周期移植不影响患者的临床结局,但其明显降低了重度OHSS的发生率,使安全性提高并降低了医疗费用。Objective To compare the outcome of two transfer policies among high-risk ovarian hyperstimulation syndrome（OHSS） patients with whole embryo freezing and thawing 2～3 cycles after egg retrieval and fresh embryo transfer.Methods The age,infertility years,reasons of infertility,body mass index（BMI）,situation of COH [the levels of initial dosage of gonadotropins（Gn）,days of COH,total dosage of Gn,thickness of membrane,level of estradiol（E2）,size of the ovary on day of human chofinonic gonadotropin（HCG）],number of retrieved oocytes,number of good embryos,incidence of significant OHSS,biochemistry and clinical pregnancy rates were compared among 122 patients with whole embryo freezing and thawing ET（group A）and 145 patients with the ET cycle（group B）.Results There were no significant differences in patient age,infertility years,reasons of infertility,BMI,situation of COH,number of retrieved oocytes,number of good embryos.The incidence of significant OHSS occurred in group A（2.46%） was lower than that in group B（8.28%）（P0.05）.There were no differences in biochemistry pregnancy rate（50.0% vs 47.6%）and clinical pregnancy rate（36.9% vs 33.8%）between group A and group B.Conclusion The outcome of freezing the whole embryos and thawing ET 2-3 cycles after egg retrieval is not better than transferring fresh embryo in IVF-ET,but the group A definitely reduces the incidence of significant OHSS,improves the security and cuts down medical expenses.

关 键 词：卵巢过度刺激综合征 胚胎移植 冷冻 低温保存 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学] R321.3[医药卫生—基础医学]