阴道超声下最大卵泡经线及主导卵泡群比例对体外受精-胚胎移植结局的影响  

Assess the impact of the diameter of largest follicular and the proportion of dominant follicle group by transvaginal ultrasound on clinical outcomes of in vitro fertilization-embryo transfer

作　　者：张少娣[1] 路锦[1] 耿嘉瑄[1] 王雪[1] 张翠莲[1] 

机构地区：[1]河南省人民医院郑州大学人民医院生殖医学研究所,郑州450000

出　　处：《现代妇产科进展》2014年第9期724-727,共4页Progress in Obstetrics and Gynecology

摘　　要：目的：分析人绒毛膜促性腺激素（HCG）注射日最大卵泡直径及主导卵泡群比例对体外受精-胚胎移植（IVF-ET）结局的影响,以探讨HCG扳机的超声标准。方法：回顾分析2010年6月至2012年6月在河南省人民医院生殖所接受IVF-ET治疗的患者共2566周期,根据HCG日最大卵泡径线（D）分为：A组（D≤18mm）、B组（18mm27mm）,比较5组的年龄、基础FSH、HCG日E2、HCG日≥14mm卵泡数、HCG日主导卵泡比例、2PN数、可移植胚胎数、胚胎着床率、临床妊娠率等。结果：A、B组HCG日≥14mm卵泡数、HCG日≥20mm比例及HCG日≥18mm比例显著低于其余3组,A组显著低于B组,差异均有统计学意义（P〈0.001）：A、B组的HCG日≥16mm比例、胚胎着床率、临床妊娠率均低于C、D、E组,差异有统计学差异（P〈0.001）。5组患者的年龄、基础FSH、卵子数、2PN数、可移植胚胎数、早期流产率等比较,差异均无统计学意义（P〉0.05）。结论：HCG日扳机的超声标准应以主导卵泡群比例为主要参考指标并兼顾最大卵泡直径,各主导卵泡群的比例：HCG日≥20mm卵泡比例35%、≥18mm卵泡比例55%～60%、≥16mm卵泡比例80%;最大卵泡直径〉21mm。Objective ：To analyze the diameter of largest follicular and the proportion of dominant follicle group on human chorionic gonadotropin （HCG） injection day on clinical outcomes of in vitro fertilization-embryo transfer（IVF-ET） ,to investigate the ultrasound standards of HCG trigger. Methods：A total of 2566 cycles IVF-ET from June 2010 to June 2012 in our reproductive center were evaluated retrospectively in the study. Cycles were divided into five groups according to the diameter of largest follicular on HCG day ： group A （ D ≤ 18 mm） , group B（18〈D≤21 mm）,group C（21〈D≤24mm）,group D（24〈D≤27mm） and group E （D〉 27 mm） , The age, bFSH, E2 level on HCG day, the number of follicular≥ 14mm, the proportion of dominant follicle group,2PN, available embryos, clinical pregnancy rate of the IVF-ET were analyzed comparatively. Results： The follicle （ diameter ≥14mm） number and the proportion of dominant follicle（diameter≥20mm and diameter≥18mm） on HCG day in group A and B were significantly lower than the other four groups （P〈0.001）. The proportion of follicle diameter≥16mm on HCG day,the clinical pregnancy rate and embryo implantation rate were significantly lower in group A and B than group C, group Dand group E （P〈0.05）. The age,bFSH, number of oocytes and 2PN, available embryos early abortion rate between five groups were not statistically different （P〉0.05）. Conclusion ： The p proportion of dominant follicle group, and the proportion of dominant follicle group：diameter diameter ≥ 16mm 80%. The largest follicular rincipal ultrasound factor for HCG trigger is the largest follicular diamete is a minor factor, the ≥20mm 35% ,diameter≥ 18mm 55% - 60% diameter〉21 mm.

关 键 词：体外受精-胚胎移植 主导卵泡 卵泡直径 HCG扳机 临床妊娠率 胚胎着床率 

分 类 号：R711[医药卫生—妇产科学]