延迟取卵补救措施对空卵泡综合征患者体外受精-胚胎移植妊娠结局的影响  

Effect of delayed oocyte retrieval on pregnancy outcome of IVF-ET in patients with empty follicle syndrome

作　　者：潘丹 杨杰 文雯 王磊 王瑞 孟彬 于玲 师娟子 周寒鹰 PAN Dan;YANG Jie;WEN Wen;WANG Lei;WANG Rui;MENG Bin;YU Ling;SHI Juan-zi;ZHOU Han-ying(Northwest Women’s and Children’s Hospital,Xi’an 710004)

机构地区：[1]西北妇女儿童医院,西安710004

出　　处：《生殖医学杂志》2023年第2期188-194,共7页Journal of Reproductive Medicine

基　　金：陕西省中医药管理局科研课题(临床类研究课题)(2019-ZZ-LC045)。

摘　　要：目的探究IVF/ICSI取卵周期中,当发生空卵泡综合征时,采取延迟取卵补救措施对妊娠结局的影响。方法本研究为回顾性队列研究。收集2019年1月至2021年12月期间在西北妇女儿童医院行IVF/ICSI-ET助孕患者的资料(共72个周期)。当取卵日穿刺3枚卵泡未获卵时,根据是否延迟取卵将患者分为正常取卵组(不暂停取卵手术,继续完成全部目标卵泡穿刺)45个周期和延迟取卵组(暂停取卵手术,测血清β-HCG≥40 U/L时,延迟3~4 h再次穿刺剩余目标卵泡)27个周期。比较两组患者的一般资料、促排卵及胚胎发育情况、鲜胚及冻胚移植妊娠结局,并采用Logistic回归分析累积活产率的影响因素。结果延迟取卵组患者的年龄、不孕年限、促排卵方案、预计获卵数、可用胚胎数、优质胚胎数、提前排卵率、授精失败率、无可用胚胎率与正常取卵组比较均无显著性差异(P均>0.05);延迟取卵组患者的实际获卵数[(3.74±2.75)vs.(3.04±1.64)]、MⅡ卵数[(4.83±3.60)vs.(2.50±1.38)]显著高于正常取卵组(P<0.05)。两组鲜胚移植周期及冻胚移植周期的单胚胎移植比例、移植囊胚比例、移植优胚比例及活产率均无显著性差异(P均>0.05)。两组累积活产率比较,延迟取卵组的累积活产率略高于正常取卵组,但尚无显著性差异(P>0.05)。通过Logistic回归分析校正混杂因素后提示实际获卵数与累积活产率之间存在显著正相关(P<0.05),实际获卵数越多,累积活产率越高。结论当取卵日穿刺3枚卵泡未获卵时,可延迟3~4 h再取卵,可以获得更多的卵子尤其是成熟卵子,可能间接提高累积活产率。Objective:To explore the effect of delayed oocyte retrieval on pregnancy outcome when empty follicle syndrome occurs in IVF/ICSI.Methods:This study is a retrospective cohort study.The data of 72 IVF/ICSI cycles in Northwest Women’s and Children’s Hospital from January 2019 to December 2021 were collected.When 3 follicles were punctured on the day of oocytes retrieval and no oocytes were found,the patients were divided into normal oocytes retrieval group(without suspending oocytes retrieval,continue to complete all target follicle puncture,n=45 cycles)and delayed oocytes retrieval group(suspending oocytes retrieval;when serumβ-HCG≥40 U/L,the remaining target follicles were punctured again after 3-4 hours delay,n=27 cycles).The general data,ovulation induction and embryo development,pregnancy outcome of fresh embryo and frozen embryo transfer were compared between the two groups.Logistic regression was used to analyze the influencing factors of cumulative live birth rate.Results:There were no significant differences in age,infertility years,ovulation induction protocol,expected number of oocytes retrieved,available number of embryos,high-quality embryos,early ovulation rate,insemination failure rate and unavailable embryos rate between the delayed oocytes retrieval group and the normal oocytes retrieval group(P>0.05).Compared with the normal oocyte retrieval group,the actual number of oocytes retrieved[(3.74±2.75)vs.(3.04±1.64)]and the number of MⅡoocytes[(4.83±3.60)vs.(2.50±1.38)]in the delayed oocytes retrieval group were significantly higher than those in the normal oocytes retrieval group(P<0.05).There were no significant differences in the proportion of single embryo transfer,the proportion of blastocysts transfer,the proportion of excellent embryos transfer and the live birth rate in fresh embryo transfer and frozen embryo transfer between the two groups(P>0.05).The cumulative live birth rate of the delayed oocytes retrieval group was slightly higher than that of the normal group,but there was no

关 键 词：空卵泡综合征 延迟取卵 体外受精/卵胞浆内单精子注射 胚胎移植 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]