卵泡期长效长方案在卵巢高储备人群中的最佳获卵数分析  

Optimum number of oocytes retrieved of follicular phase long-acting long protocol in patients with high ovarian reverse

作　　者：代玮[1] 胡琳莉[1] Dai Wei;Hu Linli(Reproductive Medical Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院生殖医学中心,450052

出　　处：《中华生殖与避孕杂志》2020年第4期265-270,共6页Chinese Journal of Reproduction and Contraception

摘　　要：目的观察卵泡期长效长方案应用于卵巢高储备人群的临床特征及最佳获卵数分析。方法回顾性分析2015年8月至2019年7月期间在郑州大学第一附属医院生殖医学中心接受第一周期体外受精/卵胞质内单精子注射(IVF/ICSI)助孕、采用卵泡期长效长方案助孕的5168例卵巢多囊样改变/多囊卵巢综合征(PCO/PCOS)患者的临床资料,根据取卵后是否因卵巢高反应行全部胚胎冷冻分为高反应冷冻胚胎组及对照组,根据移植后是否发生中重度卵巢过度刺激综合征(OHSS)分为中重度OHSS组及对照组。根据获卵数分为6组:<6、6~10、11~15、16~20、21~25和≥26。比较各分组间的临床特征及不同获卵数分组的临床妊娠率、高反应冷冻胚胎率、中重度OHSS率。采用logistics回归分析获卵数与卵巢高反应及移植后中重度OHSS的相关性。结果在使用卵泡期长效长方案的PCO/PCOS周期中,获卵数6~10、11~15、16~20能获得满意的临床妊娠率(72.05%、74.29%、76.17%)及较低的高反应冷冻胚胎率(2.46%,10.01%,23.59%)。矫正混杂因素后,获卵数是影响卵巢高反应全部胚胎冷冻的独立因素(OR=2.159,95%CI=2.027~2.300,P<0.001),与移植后中重度OHSS无明显相关性(OR=0.755,95%CI=0.553~1.031,P=0.077)。结论对于PCO/PCOS患者采用卵泡期长效长方案,获卵数6~20枚可达到满意的周期结局。Objective To observe the clinical characteristics and the optimum number of oocytes retrieved of follicular phase long-acting long protocol in patient with high ovarian reverse.Methods A total of 5168 patients with polycystic ovary/polycystic ovary syndrome(PCO/PCOS)underwent in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)in Reproductive Medical Center,the First Affiliated Hospital of Zhengzhou University from August 2015 to July 2019 were retrospectively identified.The cycles were divided into two groups according if“freeze all embryos”for high ovarian response,divided into groups according to whether the patients underwent moderate to severe ovarian hyperstimulation syndrome(OHSS)after embryo transfer,and divided into six groups for the number of oocytes retrieved:<6,6-10,11-15,16-20,21-25,≥26.Clinical characteristics,clinical pregnancy rate,freeze-all rate for high response and moderate to severe OHSS rate after embryo transfer in different groups were compared.Logistic regression analysis was used to analyze the correlation of the number of oocytes retrieved to high ovarian response and the moderate or severe OHSS occurence after embryo transfer.Results In IVF cycles stimulated with follicular phase long-acting long protocol,the optimal number of oocytes for achieving clinical pregnancy was 6-10,11-15,16-20(72.05%,74.29%,76.17%),and also had a lower chance of all embryo frozen rate(2.46%,10.01%,23.59%).The number of oocytes retrieved was associated with embryo frozen rate(OR=2.159,95%CI=2.027-2.300,P<0.001),and not associated with moderate to severe OHSS after embryo transfer(OR=0.755,95%CI=0.553-1.031,P=0.077).Conclusion The optimal number of oocytes for PCO/PCOS patient stimulated with follicular phase long-acting long protocol is between 6 and 20.

关 键 词：促性腺激素释放激素激动剂长方案 长效促性腺激素释放激素激动剂 卵巢高储备 卵巢高反应 卵巢过度刺激综合征 

分 类 号：R714[医药卫生—妇产科学]