不同助孕策略在卵巢低反应患者中的应用价值  

Application value of different strategies of assisting pregnancy in patients with low ovarian response

作　　者：李昕妍 王志强[1] 柴三明[1] 王琰[1] 张霖[1] 晏博 倪亚莉[1] LI Xin-Yan;WANG Zhi-Qiang;CHAI San-Ming(Reproductive Medicine Center of Maternal and Child Health Hospital of Gansu Province,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院生殖医学中心,甘肃兰州730050

出　　处：《中国妇幼保健》2022年第11期2018-2021,共4页Maternal and Child Health Care of China

基　　金：甘肃省科技计划项目(18YF1WA045);甘肃省自然科学基金项目(1506RJZA159)。

摘　　要：目的比较不同助孕方案在卵巢低反应患者中的应用效果,为探索卵巢低反应患者接受辅助生殖治疗的最佳策略提供理论依据。方法回顾性分析2016年12月—2019年2月在甘肃省妇幼保健院生殖医学中心接受辅助生殖治疗的948例患者,根据不同促排卵方案分为A、B、C、D 4组。采用方差分析、Welch检验、χ^(2)检验比较不同促排卵方案以及不同受精方式中MⅡ卵率、受精率、优质胚胎率、可利用胚胎率、囊胚形成率、胚胎种植率以及临床妊娠率的差异,探讨适用于卵巢低反应患者接受辅助生殖治疗的最佳策略。结果不同超排卵方案中,A组的优质胚胎率、可利用胚胎率低于B、C、D 3组;C组种植率高于A、D两组,D组的临床妊娠率低于A组和C组,MⅡ卵率、受精率及囊胚形成率的差异无统计学意义(P>0.05);不同受精方式中,体外受精(IVF)的可利用胚胎率、囊胚形成率高于卵胞质内单精子注射(ICSI)受精方式。结论高孕激素状态下促排卵(PPOS)方案在卵巢低反应患者接受辅助生殖治疗过程中具有一定的应用优势。同时,采用IVF受精后胚胎的后续发育潜能与ICSI受精相比具有一定的优势。Objective To compare the effects of different assisted pregnancy programs in patients with low ovarian response,and to provide a theoretical basis for exploring the best strategy for patients with low ovarian response to assisted reproductive therapy.Methods A retrospective analysis of 948 patients who received assisted reproductive treatment at the Reproductive Medicine Center of Gansu Provincial Maternity and Child Health Hospital from December 2016 to February 2019 was divided into groups A,B,C,and D according to different ovulation induction programs,and analysis of variance was used.,Welch test,χ^(2) test to compare the difference of MII egg rate,fertilization rate,high-quality embryo rate,available embryo rate,blastocyst formation rate,embryo implantation rate and clinical pregnancy rate in different ovulation induction schemes and different fertilization methods,and discuss the application of The best strategy for patients with low ovarian response to assisted reproductive therapy.Results Among the different superovulation schemes,the high-quality embryo rate and available embryo rate in group A were lower than those in groups B,C,and D;the implantation rate in group C was higher than that in groups A and D,and the clinical pregnancy rate in group D was lower than that in group A.Compared with group C,there was no statistically significant difference in the egg rate,fertilization rate and blastocyst formation rate of MⅡ.Among the different fertilization methods,the available embryo rate and blastocyst formation rate of IVF fertilization were higher than that of ICSI fertilization.Conclusion The PPOS scheme has certain advantages in the application of assisted reproductive therapy in patients with low ovarian response.At the same time,the subsequent development potential of embryos after IVF fertilization has certain advantages compared with ICSI fertilization.

关 键 词：卵巢低反应 超排卵方案 受精方式 优质胚胎率 临床妊娠率 辅助生殖 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]