优势卵泡的选择对多囊卵巢综合征不孕症患者自然周期临床结局的影响  

Effect of the dominant follicle selection on the clinical outcome of infertile patients with polycystic ovary syndrome in natural cycle

作　　者：李建华 焦婷婷 范晶晶 成彦彬 李常山 徐野 张水文 LI Jian-hua;JIAO Ting-ting;FAN Jing-jing(Center of Reproductive Medicine and Genetics,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;College of Biological and Agricultural Engineering,Weifang University,Weifang,Shandong 261061,China)

机构地区：[1]中国人民解放军总医院第七医学中心生殖医学科,北京100700

出　　处：《中国优生与遗传杂志》2020年第10期1269-1272,共4页Chinese Journal of Birth Health & Heredity

基　　金：国家自然科学基金(81401271)。

摘　　要：目的探讨优势卵泡的募集和选择是否影响多囊卵巢综合征(PCOS)患者自然周期未成熟卵母细胞体外培养的临床结局。方法根据筛查标准,将PCOS患者治疗方案分为2种类型:有优势卵泡募集组采用自然周期IVF结合IVM(自然周期IVF/M)技术;无优势卵泡募集组采用IVM技术。结果在235个取卵周期中,有优势卵泡募集组占21.7%,无优势卵泡募集组占78.3%。IVM组的平均获卵数(14.7±8.8)和未成熟卵母细胞数(13.3±8.0)显著高于自然周期IVF/M组(10.3±5.9)和(8.5±5.9)(P<0.01),而其未成熟卵母细胞体外成熟率(70.7%)显著低于自然周期IVF/IVM(84.3%)(P<0.01)。两组之间的受精率和卵裂率无显著差异。两组之间临床妊娠率和流产率也无显著差异,IVM组临床妊娠率(45.6%)略高于IVF/M组(40.4%);IVM组流产率(23.2%)略高。结论优势卵泡的募集和选择不影响PCOS患者的临床结局,可以根据优势卵泡是否募集采用自然周期IVF/M和IVM技术进行治疗,这两种方案都是PCOS患者安全有效的助孕方式。Objective:To explore whether the selection of dominant follicle could influence the clinical outcomes for PCOS patients with natural cycle.Methods:According to the selection of dominant follicle,the cycles were divided into 2 groups:when the dominant follicle was selected during the oocyte pickup cycle,natural cycle IVF combined IVM(natural cycle IVF/M)was performed;in IVM group,the dominant follicle was not selected during the cycle.Results:The mean number of collected oocytes(14.7±8.8)and immature oocytes(13.3±8.0)in IVM group was significantly higher than those(10.3±5.9 and 8.5±5.9,respectively)in natural cycle IVF/M group(P<0.01).The rate of IVM was significant higher(84.3%)in natural cycle IVF/M group than that in IVM group(70.7%).There were no significant differences in the rates of in vitro fertilization and cleavage as well as the clinical pregnancy(40.4% and 45.5%)and live birth rates between 2 subgroups.Conclusion:Both natural cycle IVF/M and IVM could be efficient treatment alternative for PCOS infertility treatment whether or not the dominant follicle was selected.

关 键 词：多囊卵巢综合征 自然周期IVF IVM 优势卵泡 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]