微刺激全部胚胎冷冻方案在常规体外受精-胚胎移植失败的卵巢低反应患者中的应用  

Application of mild stimulation protocol in poor responders after failure of routine in vitro fertilization-embryo transfer

作　　者：孔娜[1] 刘景瑜[1] 陈华[1] 王玢[1] 孙海翔[1] 

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,210009

出　　处：《中华生殖与避孕杂志》2017年第8期614-618,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨微刺激全部胚胎冷冻方案在常规体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)方案失败的卵巢低反应(POR)患者中的应用价值。方法对196例IVF/ICSI-ET应用常规促排卵方案因POR放弃周期或移植失败后改用微刺激方案的402个周期进行回顾性分析,比较前、后2次不同促排卵方案的临床和实验室指标。结果 402个微刺激周期中32个周期取消,周期取消率为7.96%,370个周期获得卵母细胞,平均获卵数(2.2±1.5)个,共233个周期有胚胎冷冻,胚胎冷冻率为57.96%,共194个周期进行了ET,临床妊娠74例,早期自然流产6例,起始周期累积妊娠率为37.75%(74/196),冻融胚胎移植(FET)周期临床妊娠率为38.14%(74/194),其中≤37岁组FET周期的临床妊娠率(50.89%)明显高于>37岁组(20.73%)(P<0.05)。微刺激方案的临床和实验室指标均显著优于常规长方案。结论微刺激全部胚胎冷冻方案对常规方案IVF/ICSI-ET治疗失败的POR患者具有疗程短、刺激剂量小,获卵率高、可利用胚胎率高、周期取消率低等特点,对于该类患者再次助孕可考虑微刺激方案。ObjectiveTo explore the clinical value of mild stimulation protocol applied in poor ovarian responders after failure of routine in vitro fertilization/intracytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）.MethodsA total of 196 poor ovarian responders were initially taken by pituitary down regulation protocols. After unsuccessful pregnancy, another 402 mild stimulation protocols were applied. A retrospective study was performed to compare the data and clinical outcomes between the two protocols of the same patients.ResultsTotally 32 cycles were canceled in the total 402 mild stimulation cycles, the cancelleration rate was 7.96%. Among 370 cycles obtained oocytes, the mean number of oocytes obtained was 2.2±1.5. A total of 233 cycles owned frozen embryos, fertilization rate was 57.96%. Seventy-four clinical pregnancies were got in the 194 transfer cycles, 6 were aborted, the frozen rate was 27.68% （98/354）, the pregnancy rates per starting cycles and per transfer cycle was 37.75% （74/196） and 38.14% （74/194）, respectively. Clinical and labortary indexes were better in mild stimulation than routine stimulating ovulation cycles.ConclusionMild stimulation protocol is cheaper, easier to use, short stimulation days, less stress and produces less complications compared with the standard protocol when used in poor responders after failure of routine IVF-ET.

关 键 词：微刺激方案 卵巢低反应(POR) 体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET) 

分 类 号：R714.8[医药卫生—妇产科学]