卵泡输出率在下丘脑垂体性闭经患者体外受精-胚胎移植中的应用研究  

Application of follicular output rate in IVF-ET in patients with hypothalamic-pituitary amenorrhea

作　　者：王含必[1] 汤鲜[1] 温晓晓[1] 刘美芝[1] 张颖[1] 邓成艳[1] WANG Han-bi TANG Xian WEN Xiao-xiao LIU Mei-zhi ZHANG Ying DENG Cheng-yan(Department of Obstetrics ＆ Gynecology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Science,Beijing 100730)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院妇产科,北京100730

出　　处：《生殖医学杂志》2017年第5期442-446,共5页Journal of Reproductive Medicine

摘　　要：目的探索卵泡输出率(FORT)在接受体外受精-胚胎移植(IVF-ET)治疗的下丘脑垂体性闭经(HH)患者的卵巢反应性及妊娠结局的预测作用。方法收集北京协和医院生殖中心IVF-ET治疗的40例HH患者共60个周期,按FORT值将其分为高(FORT≥100%)、中(100%>FORT≥50%)、低(FORT<50%)三组,回顾性分析三组间控制性促排卵治疗过程中的临床及实验室数据。结果高、中、低三组窦卵泡数分别为(7.1±2.7)、(9.6±5.3)和(10.7±5.4)个,FORT值越高者窦卵泡数量越少,差异具有统计学意义(P<0.05);经外源性促性腺激素治疗后,药物使用剂量及天数在三组间无统计学差异(P>0.05);高、中、低三组间HCG日的雌激素(E2)水平[分别为(12 918.77±7 472.12)pmol/L、(9 716.33±5 872.00)pmol/L和(6 556.82±3 780.83)pmol/L]、排卵前卵泡数量[分别为(8.7±2.6)、(6.9±2.9)和(4.9±2.3)个]、获卵数[分别为(9.3±3.8)、(7.8±3.3)和(6.5±3.0)个]、MII卵数[分别为(7.8±4.2)、(6.3±3.2)和(5.4±2.5)个]均有统计学差异(P<0.05);而优胚数、胚胎种植率、冷冻胚胎数、临床妊娠率等三组间均无统计学差异(P>0.05)。结论对于HH患者,FORT可有效地指示IVF-ET过程中的卵泡对Gn的反应性,高FORT值患者将有机会获得更多的成熟卵母细胞,而对妊娠结局的预测作用有待更大样本量的研究证实。Objective：To explore the predictive value of follicular output rate（FORT）in IVF-ET cycle in the patients with hypogonadotropic hypogonadism（HH）.Methods：A total of 60IVF-ET cycles in 40 HH patients were studied.The cycles were divided into three groups according the FORT value：low（50%）,medium（100% FORT≥50%）and high（≥100%）FORT groups.The clinical and laboratory parameters of controlled ovarian hyperstimulation and IVF-ET in the three groups were retrospectively analyzed.Results：The antral follicle count was increased progressively from low to the high FORT group（7.1±2.7,9.6±5.3and 10.7±5.4,respectively,P〈0.05）.The total dosage and days of gonadotropin used were not significantly different among the three groups（P〉0.05）.However,The serum E2 levels on HCG day（12 918.77±7 472.12,9 716.33±5 872.00,6 556.82±3 780.83pmol/L,respectively）,the number of follicles before ovulation（8.7±2.6,6.9±2.9,4.9±2.3,respectively）,the number of oocytes retrieved（9.3±3.8,7.8±3.3,6.5±3.0,respectively）and number of MII oocytes（7.8±4.2,6.3±3.2,5.4±2.5,respectively）were significantly higher in the high FORT group than those in other two groups（all P〈0.05）.There were no differences in the number of high quality embryo,embryo implantation rate,number of frozen embryos,and clinical pregnancy rate in the three groups.Conclusions：Follicular output rate may be used as a qualitative reflector for reactivity of follicles to gonadotropin in IVF-ET cycle in HH patients.High FORT may have more chance of getting more maturation oocytes.The predictive effect on pregnancy outcome remains to be confirmed by a larger sample size

关 键 词：卵泡输出率 下丘脑垂体性闭经 体外受精-胚胎移植 控制性超排卵 窦卵泡 卵巢反应性 

分 类 号：Q132[生物学—普通生物学]