拮抗剂方案中卵泡期长度对IVF/ICSI-ET患者妊娠结局的影响  

Effects of follicular phase length in GnRH antagonist protocol on pregnancy outcome of patients undergoing IVF/ICSI-ET

作　　者：黄园 梁耀允 陈曾春晓 王珺 黄官友 胡竹 赵淑云 HUANG Yuan;LIANG Yao-yun;CHEN Zeng chun-xiao;WANG Jun;HUANG Guan-you;HU Zhu;ZHAO Shu-yun(Center for Reproductive Medicine,The Affiliated Hospital of Guizhou Medical University,Guiyang 550025;Clinical Medical College of Guizhou Medical University,Guiyang 550004)

机构地区：[1]贵州医科大学附属医院生殖中心,贵阳550025 [2]贵州医科大学临床医学院,贵阳550004

出　　处：《生殖医学杂志》2023年第5期665-670,共6页Journal of Reproductive Medicine

基　　金：贵州省科技计划项目[黔科合基础-ZK(2021)一般375];贵阳市科技计划项目(筑科合同[2019]9-1-1,筑科合同[2019]9-1-25)。

摘　　要：目的 探讨拮抗剂方案中不同卵泡期长度对体外受精/卵胞浆内单精子注射(IVF/ICSI)鲜胚移植周期妊娠结局的影响。方法 回顾性分析2020年1月至2022年1月在贵州医科大学附属医院生殖中心行IVF/ICSI鲜胚移植且采用拮抗剂方案促排卵的529例患者的临床资料,按照卵泡期长度分成A组(卵泡期长度≤12 d,n=178)、B组(13 d≤卵泡期长度≤14 d,n=255)和C组(卵泡期长度≥15 d,n=96),比较3组患者的基础资料、促排卵情况、妊娠结局。采用Logistic多因素回归分析影响HCG阳性率的独立因素。结果 基础资料比较,B组的不孕年限显著低于C组,基础窦卵泡数(AFC)显著高于C组(P均<0.05);A组的体质量指数(BMI)显著低于B、C组,基础E_(2)显著高于B、C组(P均<0.05);其余基线资料均无显著性差异(P>0.05)。A组的Gn天数、Gn总量、HCG日E_(2)水平、HCG日P水平、获卵数、MⅡ数在3组中最低(P均<0.05);B组的Gn天数、Gn总量显著低于C组(P<0.05),获卵数、MⅡ数显著高于C组(P<0.05);B组的2PN数显著高于A组(P<0.05);其余促排卵指标3组间无显著性差异(P>0.05)。B组的HCG阳性率(52.55%)显著高于A组(41.57%)(P<0.05),种植率和临床妊娠率有高于其他两组的趋势,但尚无显著性差异(P>0.05)。多因素Logistic回归分析结果显示女方年龄和Gn天数是HCG阳性率的独立危险因素(P<0.05)。结论 拮抗剂方案促排卵过程中保持卵泡期在合理长度可能有利于改善新鲜移植周期的妊娠结局。Objective:To investigate the effect of different follicular phase lengths in GnRH antagonist protocol on pregnancy outcome in patients undergoing IVF/ICSI-ET.Methods:The clinical data of 529 patients who underwent IVF/ICSI-ET with GnRH antagonist protocol for ovulation induction in our hospital from January 2020 to January 2022 were retrospectively analyzed.According to the follicular phase length,they were divided into three groups:group A(follicular phase length≤12 days,n=178),group B(13 days≤follicular phase length≤14 days,n=255)and group C(follicular phase length≥15 days,n=96).The basic data,ovulation induction status and pregnancy outcomes were compared among the three groups.Multivariate logistic regression analysis was used to analyze the independent factors affecting HCG positive rate.Results:In comparison of the basic data,the infertile years in group B was significantly less than that in group C(P<0.05),but the number of basal antral follicles(AFC)was significantly more than that in group C(P<0.05).Body mass index(BMI)of group A was significantly lower than that of group B and C,and basal E_(2) level was significantly higher than that of group B and C(P<0.05).There was no significant difference in other baseline data(P>0.05).The days and total amount of Gn,E_(2) and P levels on the HCG day,and the number of oocytes retrieved,MⅡin the group A were the lowest among the three groups(P<0.05).The days and total doses of Gn used in group B were significantly lower than those in the group C(P<0.05),but the number of oocytes retrieved,MⅡin group B were significantly higher than those in the group C(P<0.05).The number of 2PN in group B was significantly higher than that in group A(P<0.05).There was no significant difference in other ovulation promotion indexes among the three groups(P>0.05).The HCG positive rate in group B(52.55%)was significantly higher than that in group A(41.57%)(P<0.05).The implantation rate and clinical pregnancy rate were higher than those in the other two groups,but there was

关 键 词：拮抗剂方案 体外受精-胚胎移植 卵泡期长度 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]