国医大师夏桂成“7、5、3奇数律”与体外受精-胚胎移植扳机时机相关性的临床研究  

Clinical Study on the Correlation between"Seven-Five-Three"Odd Number Regular Pattern by National Distinguished Master Xia Guicheng and the Trigger Timing of in vitro Fertilization-Embryo Transfer

作　　者：陈婕 殷燕云[1] 谈勇[2] 黄文青 邹奕洁[1] 唐培培[1] 王飞虹[1] CHEN Jie;YIN Yan-yun;TAN Yong;HUANG Wen-qing;ZOU Yi-jie;TANG Pei-pei;WANG Fei-hong(The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China;The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China)

机构地区：[1]南京中医药大学附属医院/江苏省中医院,江苏南京210029 [2]南京中医药大学第一临床医学院,江苏南京210023

出　　处：《南京中医药大学学报》2021年第6期847-852,共6页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：江苏省妇幼健康科研项目(F201676);江苏省中医院高峰人才项目(y2018rc36);江苏省中医院院级创新发展基金专项课题(Y2019CX17)。

摘　　要：目的观察体外受精/卵胞浆内单精子注射-胚胎移植(In vitro fertilization/Intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)长方案周期中最佳扳机日是否与国医大师夏桂成教授提出的“7、5、3奇数律”相符,以及对卵泡及胚胎发育情况及妊娠结局的影响。方法回顾性分析426例因女方因素首次接受IVF/ICSI-ET长方案周期,根据促性腺激素(Gonadotropin,Gn)启动日至扳机日是否符合“7、5、3奇数律”,分为数律扳机组与非数律扳机组,比较Gn天数、Gn用量及获卵率、受精率、2原核(2 Pronucleus,2PN)率、可移植胚胎率、临床妊娠率、活产率等。结果①按“7、5、3奇数律”扳机组186例,其获卵率、2PN率、可移植胚胎率、临床妊娠率、活产率均显著高于非数律扳机组(P<0.05,P<0.01)。②3数律亚组中,按数律扳机组受精率显著高于非数律扳机组(P<0.01);5数律亚组中,按数律扳机组Gn天数及Gn总量显著低于非数律扳机组(P<0.01),按数律扳机组获卵率、可移植胚胎率、临床妊娠率均显著高于非数律扳机组(P<0.05,P<0.01);7数律亚组中,按数律扳机组可移植胚胎率显著高于非数律扳机组(P<0.05)。结论国医大师夏桂成教授提出的“7、5、3奇数律”适用于IVF/ICSI-ET长方案周期扳机日的确立,按7、5数律扳机可提高可移植胚胎率,5数律扳机可升高临床妊娠率与活产率,3数律扳机可增加受精率。OBJECTIVE To observe whether the optimal trigger day in in vitro fertilization/intra cytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)long protocol cycles is conformed to the"seven-five-three"odd number regular pattern by national distinguished master Xia Guicheng,as well as its effect on follicular and embryonic development and pregnancy outcome.METHODS A total of 426 cases who underwent IVF/ICSI-ET for the first time due to female factor,they were divided into numerical trigger group and non-numerical trigger group according to whether the gonadotropin(Gn)initiation date to the trigger date conformed to the seven-five-three odd number regular pattern.In addition,we compared the Gn days,Gn dosage,egg acquisition rate,fertilization rate,2 pronucleus(2 PN)rate,transferable embryo rate,clinical pregnancy rate,and live birth rate.RESULTS①The egg acquisition rate,2PN rate,transferable embryo rate,clinical pregnancy rate and live birth rate of 186 cases in the seven-five-three odd number regular pattern trigger group were significantly higher than those in the non-numerical trigger group(P<0.05,P<0.01).②As to"three"regular pattern subgroup,the fertilization rate was significantly higher in the numerical trigger group than that in the non-numerical trigger group(P<0.01);As to"five"regular pattern subgroup,the Gn days and the total number of Gn in the numerical trigger group were significantly lower than those in the non-numerical trigger group(P<0.01);The egg acquisition rate,embryo transferability rate and clinical pregnancy rate were significantly higher in the numerical trigger group than those in the non-numerical trigger group(P<0.05,P<0.01);As to"seven"regular pattern subgroup,the embryo transferability rate in the numerical trigger group was significantly higher than that in the non-numerical trigger group(P<0.05).CONCLUSION The seven-five-three odd number regular pattern proposed by Xia Guicheng,a national distinguished master,is applicable to the establishment of the trigger day of IVF/ICSI-ET long

关 键 词：中医女性生殖节律 奇数律 辅助生殖 扳机 

分 类 号：R271.4[医药卫生—中医妇科学]