卵巢反应不良患者的流产分析  

Miscarriage analysis on patients with poor ovarian response

作　　者：龙晓林[1] 吴乙璇[1] 

机构地区：[1]广州医学院第三附属医院生殖医学中心,510150

出　　处：《中华生物医学工程杂志》2013年第1期65-68,共4页Chinese Journal of Biomedical Engineering

基　　金：基金项目：广州市科技局重点项日（2011J4100047）

摘　　要：目的通过分析卵巢反应不良（POR）患者早期自然流产的情况，研究成功妊娠的POR患者卵巢反应不良与卵母细胞数量及质量的关系。方法收集2005年1月至2009年4月广州医学院第三附属医院生殖医学中心1371例体外受精一胚胎移植妊娠患者，其中58例发生POR，1313例卵巢反应正常（NOR），对比卵巢反应不良与正常患者一般临床情况和各年龄组的流产率。结果POR组年龄稍高于NOR组[（33．2±3．5）岁比（31．5±3．8）岁，P〈0．05]，所需促性腺激素剂量较大，而取卵数、移植胚胎数和可用胚胎数较少（均P〈0．05）。两组的不孕年限、原发不孕比例、促排卵天数、受精率、种植率差异均没有统计学意义。POR组的多胎妊娠率低于NOR组（15．5％比34．1％，P〈0．05）。POR组流产率为20．7％（12／58），NOR组流产率为12．6％（165／1313），差异无统计学意义（P〉0．05）。POR组≤30岁、31～35岁、／〉36岁组的流产率分别为133％、26．9％、17．6％，与NOR组同年龄组10．7％、13．8％、14．4％相比差异无统计学意义（均P〉0．05）。结论成功妊娠的POR患者流产率较NOR患者无明显升高。成功妊娠的POR患者卵巢反应不良是卵母细胞数量的减少，并不是卯母细胞质量的下降。Objective To investigate the association of poor ovarian response（POR） to the quantity and quality of oocytes by analyzing the premature miscarriage in POR patients with successful pregnancy. Methods A total of 1371 pregnant women who received in vitro fertilization in Reproductive Medical Center, The Third Affiliated Hospital, Guangzhou Medical College, between January 2005 and April 2009 were recruited. Of whom 58 had POR and 1313 normal ovarian response （NOR）. The general clinical conditions and miscarriage rate in respective age group were compared. Results Patients with POR were slightly advanced age [ （33.2 ± 3.5） years vs （31.5 ± 3.8） years, P〈0.05] , required higher dose of gonadotropin yet were featured by a comparatively lower number of oocytes for extraction, embryos for transplantation and fertilization （all P〈0.05）. Nonetheless, the between-group ditterence in the duration of infertility, proportion of primary infertility, the number of days requiring ovarian stimulation, the rate of fertilization and implantation did not reach statistical significance （all P〉0.05）. A lower rate of muhifetation was noted in patients with POR（ 15.5% vs 34. 1%, P〈0.05） , of whom the rate of miscarriage did not differ significantly from those with NOR [20.7% （12/58） vs 12.6% （165/1313 ）, P〉0.05 ]. The rates of miscarriage in patients with POR （13.3%, 26.9% and 17.6% for ≤30, 31-35 and ≥36 age groups） did not differ considerably （P〉0.05） with those in patients with NOR （10.7%, 13.8% and 14.4% ）. Conclusions POR does not contribute significantly to increased rate of miscarriage. Diminished ovarian reserve, but not reduced quality of ooeytes, constitutes the POR in patients who manage the pregnancy.

关 键 词：卵巢反应不良 流产 自然 卵母细胞 

分 类 号：R714.8[医药卫生—妇产科学]