辅助生殖技术中卵巢高反应者行冻融或新鲜单囊胚移植的结局  

Clinical observation on outcomes of patients with Ovarian hyperresponsiveness who experienced single vitrified blastocyst transfer or single fresh single blastocyst transfer in assisted reproductive technology

作　　者：黄映琴[1] 张波[1] 周红[1] 冯贵雪[1] 舒金辉[1] 林若芸[1] 李霜[1] 

机构地区：[1]广西壮族自治区妇幼保健院生殖中心,南宁530003

出　　处：《中国计划生育学杂志》2016年第2期107-110,共4页Chinese Journal of Family Planning

基　　金：公益性行业科研专项(项目编号201402004);广西自然科学基金(2013GXNSFAA019258)

摘　　要：目的：探讨体外受精-胚胎移植（IVF-ET）助孕控制性超排卵（CHO）周期中卵巢高反应患者实施新鲜单囊胚移植与冻融单囊胚移植的临床结局。方法：回顾性分析广西壮族自治区妇幼保健院生殖中心2013年1～12月行IVF助孕的卵巢高反应患者404例临床结局。其中,新鲜周期有卵巢过度刺激综合征（OHSS）风险,行首个冻融周期单囊胚移植145例（冻融周期组）;新鲜周期单囊胚移植259例（新鲜周期组）。比较两组获卵数、妊娠率、种植率、流产率、异位妊娠率、活产率等相关指标。结果：冻融周期组与新鲜周期组获卵数分别为24.3±5.7枚、19.3±3.8枚,生化妊娠率分别为78.6%、50.6%,临床妊娠率分别为74.5%、50.6%,种植率分别为74.5%、50.6%,晚期流产率分别为0,6.1%,活产率分别为64.8%、40.2%,差异均有统计学意义（P〈0.05）;而早期流产率分别为11.1%、11.5%,单卵双胎率分别为0.9%、0.8%,异位妊娠率分别为1.9%、3.1%,差异均无统计学意义（P〉0.05）。404例中OHSS发生率为3.0%,其中冻融周期组9例（6.2%）,均为中、重度早发型OHSS;新鲜周期组3例（1.2%）,均为中、重度迟发型OHSS。结论：IVF-ET中卵巢高反应行新鲜单囊胚移植及有OHSS高风险者选择冻融单囊胚移植均可有效降低OHSS发生率,而且冻融周期单囊胚移植比新鲜囊胚移植有更高的临床妊娠率及活产率。Objective： To compare the clinical outcome of patients with ovarian hyperresponsiveness who experienced fresh single blastocyst transfer （SBT） or single vitrified blastocyst transfer. All of these patients had high risk of ovari an hyperstimulation syndrome （OHSS）. Methods： From January 2013 to December 2013, 404 patients with ovarian hyperresponsiveness were included to retrospectively analyzed, who had experienced treatment of in-vitro fertilization in the reproductive medicine center, maternity and child Health care hospital of Guangxi zhuang autonomous region. The patients were divided into two groups： group A had 145 women with single vitrified blastocyst transfer; group B had 259 women with SBT.The outcomes included number of oocyte, rate of biochemical pregnancy, rate of implantation, rate of abortion, rate of ectopic pregnancy, and rate of live birth. Results： As for some outcomes, group A were significantly higher than those in group B（P〈0.05）, which included umber of oocyte（ 24.30 ± 5.74 VS. 19.29 ± 3.77 ）,（0.93% VS. 0.76%）, and rate of ectopic pregnancy（ 1.85% VS. 3.05%）.The occurrence of moderate or severe OHSS rate was 2.97% in two groups. There were 9（6.21%） women with the moderate or severe early OHSS in group A, and 3（ 1.17% ） women with symptoms of the moderate and severe later OHSS in group B. Conclusions： Fresh SBT or single vitrified blastocyst transfer using in patients patients with ovarian hyperresponsiveness can effectively decrease the occurrence of OHSS. Furthermore, vitrified blastocyst transfer can get better clinical pregnancy rate and live birth rate comparing with SBT.

关 键 词：卵巢高反应 卵巢过度刺激综合征 体外受精 全胚冷冻 单囊胚移植 

分 类 号：R714.8[医药卫生—妇产科学]