卵泡输出率评估超促排卵的卵巢反应及临床应用价值  

Value of follicular output rate in evaluating ovarian response to controlled ovarian hyperstimulation

作　　者：张红霞[1] 王丽萍[1] 付伟平[1] 方春霞[1] 朱琴[1] ZHANG Hongxia;WANG Liping;FU Weiping;FANG Chunxia;ZHU Qin(Reproductive Center of Jiaxing Maternal and Child Health Hospital,Jiaxing 436300,China)

机构地区：[1]嘉兴市妇幼保健院生殖中心,436300

出　　处：《浙江医学》2021年第10期1096-1100,共5页Zhejiang Medical Journal

基　　金：嘉兴市科技局A类计划项目(2017AY33043)。

摘　　要：目的探讨卵泡输出率(FORT)评估超促排卵的卵巢反应及指导个体化促排卵的价值。方法选择2018年1月至12月在嘉兴市妇幼保健院使用长方案超促排卵的卵巢储备功能正常不孕症患者179例,根据FORT三分位数分为低FORT组(<64.2%)、中FORT组(64.2%~87.5%)、高FORT组(>87.5%),按年龄分为<35岁组和≥35岁组。不同组别间比较年龄、基础窦卵泡数(AFC)、不孕年限、BMI、促性腺激素(Gn)起始剂量、Gn使用天数、Gn使用总量、hCG日血雌二醇、排卵前卵泡数(PFC)、获卵数、2PN受精数、优质胚胎数、2PN受精率、优质胚胎率、移植胚胎数、预防卵巢过度刺激综合征(OHSS)全胚胎冷冻率及首次胚胎移植临床妊娠率的差异。结果低FORT组、中FORT组、高FORT组患者基础AFC、hCG日血雌二醇、PFC、获卵数、预防OHSS全胚胎冷冻率、首次胚胎移植临床妊娠率比较,差异均有统计学意义(均P<0.05)。中FORT组、高FORT组基础AFC均低于低FORT组,hCG日雌二醇水平、PFC均高于低FORT组,高FORT组PFC均高于中FORT组,差异均有统计学意义(均P<0.05)。高FORT组获卵数高于低FORT组,差异有统计学意义(P<0.01)。≥35岁组不孕年限、Gn起始剂量、Gn使用总量均高于<35岁组,基础AFC、hCG日血雌二醇、PFC、获卵数、预防OHSS全胚冷冻率均低于<35岁组,差异均有统计学意义(均P<0.05)。结论FORT可评估超促排卵的卵巢反应及临床结局,高龄患者适当增加Gn用量可以获得低龄患者相似的FORT及临床结局,可以以合适FORT为目标指导个体化超促排卵。Objective To explore the value of follicular output rate(FORT)in evaluating ovarian response to controlled ovarian hyperstimulation.Methods A total of 179 women with normal ovarian reserve function who underwent controlled ovarian hyperstimulation with long protocol in Jiaxing Maternal and Child Health Hospital from January 2018 to December 2018 were enrolled in the study.According to the three quantiles of FORT,they were divided into low FORT group(<64.2%),medium FORT group(64.2%~87.5%)and high FORT group(>87.5%).According to age,they were divided into<35 years group and≥35 years group.The age,the basic antral follicular count(AFC),infertility duration,body mass index(BMI),starting dose of gonadotropin(Gn),days of Gn,total dose of Gn,serum estradiol(E2)level on HCG day,preovulatory follicle count(PFC),FORT,number of oocytes retrieved,number of 2PN fertilization,number of high-quality embryos,number of embryos transfered,2PN fertilization rate,high-quality embryo rate,the whole embryo cryopreservation rate due to the prevention of ovarian hyperstimulation syndrome(OHSS)and clinical pregnancy rate of the first embryo transfer were compared between/among groups.Results There were significant difference in basic AFC,serum E2 level on hCG day,PFC,number of oocytes retrieved,the whole embryo cryopreservation rate due to the prevention of OHSS,clinical pregnancy rate of the first embryo transfer among low FORT group,mediumFORT group and high FORT group(all P<0.05).The basic AFC in mediumFORT group and high FORT group were lower than that in low FORT group,serum E2 level on hCG day and PFC in medium FORT group and high FORT group were higher than those in low FORT group,the PFC in high FORT group was higher than that in medium FORT group,the differences were statisti-cally significant(all P<0.05).The number of oocytes retrieved in high FORT group was significant higher than that in low FORT group(P<0.01).The infertility duration,starting dose of Gn and total dose of Gn in≥35 years group were higher than those in<35

关 键 词：卵泡输出率 超促排卵 个体化 卵巢反应 

分 类 号：R714.8[医药卫生—妇产科学]