月经期取卵在卵巢低储备患者IVF-ET中的应用  

Ovum pick-up(OPU) in menstruation is feasible for diminished ovarian reserve women underwent IVF-ET

作　　者：秦宁馨[1,2] 陈秋菊[1] 匡延平[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院辅助生殖科,上海200011 [2]上海交通大学医学院九院临床医学院,上海200011

出　　处：《生殖与避孕》2016年第5期365-371,共7页Reproduction and Contraception

摘　　要：目的：探讨月经期取卵在卵巢低储备（diminished ovarian reserve，DOR）患者体外受精一胚胎移植（IVF-ET）中应用的可行性。方法：回顾性分析70例DOR行IVF／卵胞质单精子注射（ICSI）-ET治疗的不孕症患者的临床资料，比较其73个月经期取卵和270个非月经期取卵的结局。若月经2～4d阴道超声提示优势卵泡直径≥14mm且E2水平〉200ng／L则行月经期取卵，若无优势卵泡按常规促排卵方案行IVF／ICSI，观察其临床结局。结果：月经期组获卵数、成熟卵数和可用胚胎数分别为1．0±0．4个、0．8±0．4个、0（0，1）个，非月经期组分为1．6±1．2个、1．4±1．1个、1（0，1）个，组间有统计学差异（P〈0．05）。月经期组周期取消率为72．6％，显著高于非月经期组43．0％（P〈0．05）。月经期组获卵率、卵裂率、卵子利用率分别为83．1％、94．7％和34．5％，非月经期组分别为70．6％、96．7％和51．7％，组间无统计学差异（P〉0．05）。结论：尽管月经期取卵的获卵数、成熟卵数、可用胚胎数小于非月经期取卵，但获卵率、卵裂率和卵子利用率组间无统计学差异，为反复周期取消、高基础雌激素的DOR不孕症患者节约了治疗时间，提供了新的方法。Objective： To investigate the feasibility of ovum pick-up （OPU） in menstruation for diminished ovarian reserve （DOR） women by comparing in-vitro fertilization/intracytoplasmic sperm injection and embryo transfer （IVF/ICSI-ET） outcomes with non-menstruation OPU cycles. Methods： Totally 70 women diagnosed with DOR underwent 73 OPU cycles in menstruation and 270 non-menstruation OPU. Patients were programmed for OPU in menstruation if dominant follicle was monitored by transvaginal ultrasound and high estrogen level 〉200 ng/L. And they were programmed regular IVF/ICSI protocols if not. The IVF/ICSI outcomes were compared between the two groups. Results： The number of oocytes retrieved, mature oocytes and viable embryos in menstruation group were 1.0 ±0.4, 0.8 ± 0.4, 0 （0, 1）, respectively, while in non-menstruation group were 1.6 ± 1.2, 1.4± 1.1, 1 （0, 1）, respectively （P〈0.05）. There were no significant differences in oocyte retrieval rate, cleavage rate, and oocyte utilization rate between menstruation group （83.1%, 94.7%, 34.5%） and non-menstruation group （70.6%, 96.7%, 51.7%）（P〉0.05）. Conclusion： Although the number of oocytes retrieved, mature oocytes and viable embryos in menstruation group were lower than those in non-mensturation group, there were no significant differences with oocyte retrieval rate, cleavage rate, and oocyte utilization rate. The OPU in menstruation is feasible for DOR women with repeated cancellation and high basal estrogen level, saving treatment time and providing a new method for DOR patients.

关 键 词：卵巢低储备(DOR) 月经期取卵(OPU) 卵子利用率 周期取消率 

分 类 号：R714.8[医药卫生—妇产科学]