基于不同促排卵方案及受精方式对临床结局的影响分析  

Effect Analysis of Different Ovulation Induction Schemes and Fertilization Methods on Clinical Outcomes

作　　者：阮永铭[1] RUAN Yongming(Reproductive Medicine Center,Zhuhai City Maternal and Child Health Hospital,Zhuhai,Guangdong 519000)

机构地区：[1]珠海市妇幼保健院生殖医学中心,广东珠海519000

出　　处：《智慧健康》2023年第34期21-24,共4页Smart Healthcare

摘　　要：目的探究不同促排卵方案及受精方式对临床结局的影响。方法选取2020年12月—2022年12月在本院就诊的不孕症患者4428例为研究对象,根据不同的促排卵方案将所有患者分为A组(黄体期长方案,2569例)、B组(卵泡期长方案,208例)、C组(拮抗剂方案,1450例)、D组(黄体期促排卵方案,80例)、E组(克罗米芬+GN方案,82例)、F组(来曲唑+GN方案,39例),并根据不同的受精方式将所有患者分为IVF组(3221例)和ICSI组(1207例)。比较不同促排卵方案组(A、B、C、D、E、F组)患者的临床相关指标。结果不同促排卵方案组患者的临床相关指标中,B组的平均获卵数最多,E组的正常受精率、C组的可用胚胎率、优质胚胎率、优质囊胚率、B组的妊娠率最高,C组的流产率最低(P<0.05)。IVF组和ICSI组的可利用胚胎率、优质胚胎率、妊娠率、流产率对比无明显差异(P>0.05);IVF组的平均卵子数、优质囊胚率高于ICSI组,正常受精率、平均年龄低于ICSI组(P<0.05)。结论不同促排卵方案中,使用拮抗剂方案的不孕患者胚胎发育情况更好,且流产率最低,但使用卵泡期长方案患者的临床妊娠率更高;不同的受精方式中,常规IVF受精(IVF)的治疗效果优于单精子卵细胞质内注射受精(ICSI),临床可以根据不孕患者的不同情况选择合适的促排卵方案和受精方式。Objective To explore effect of different ovulation induction schemes and fertilization methods on clinical outcomes.Methods The paper chose 4428 infertile patients in the hospital from December 2020 to December 2022,and divided them into Group A(with luteal phase long protocol,2569 cases),Group B(with follicular phase rectangular protocol,208 cases),Group C(with antagonist protocol,1450 cases),Group D(with luteal phase ovulation induction protocol,80 cases),Group E(with clomiphene+GN protocol,82 cases),and Group F(with letrozole+GN protocol,39 cases)according to different ovulation induction protocols.Clinical related indicators of patients in different ovulation induction protocol groups(A,B,C,D,E,F groups)were compared.Results Among clinical indicators of patients with different ovulation induction schemes,Group B had the highest average number of retrieved eggs,while Group E had the highest normal fertilization rate,Group C had the highest available embryo rate,high-quality embryo rate,high-quality blastocyst rate,Group B had the highest pregnancy rate.Group C had the lowest miscarriage rate(P<0.05).There was no significant difference in available embryo rate,high-quality embryo rate,pregnancy rate,and miscarriage rate between IVF group and ICSI group(P>0.05).Average number of eggs and high-quality blastocyst rate in IVF group was higher than ICSI group,while normal fertilization rate and average age was lower than ICSI group(P<0.05).Conclusion Among different ovulation induction schemes,infertility patients with antagonist schemes have better embryonic development and the lowest miscarriage rate,patients with follicular phase rectangular schemes have higher clinical pregnancy rate.Among different fertilization methods,routine IVF(IVF)has better curaitve effect than intracytoplasmic injection of sperm(ICSI).Clinically,appropriate ovulation induction and fertilization methods can be chosen based on different conditions of infertile patients.

关 键 词：促排卵方案 体外受精 卵胞浆内单精子注射 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]