高龄女性卵泡输出率对体外受精-胚胎移植结局的影响研究  

The influence of follicular output rate on outcomes of in vitro fertilization and embryo transfer in aged women

作　　者：魏家静 叶飞 曾玖芝 张亚南 熊东升 陈福锐 龚衍 Wei Jiajing;Ye Fei;Zeng Jiuzhi;Zhang Yanan;Xiong Dongsheng;Chen Furui;Gong Yan(Reproductive Medicine Center,Sichuan Provincial Women's and Children's Hospital,The Affiliated Women's and Children's Hospital of Chengdu Medical College,Chengdu Sichuan 610045;Clinical Medicine,Chengdu Medical College,Chengdu Sichuan 610500,P.R.China)

机构地区：[1]四川省妇幼保健院·成都医学院附属妇女儿童医院生殖医学中心,四川成都610045 [2]成都医学院临床医学院,四川成都610000

出　　处：《中国计划生育和妇产科》2024年第9期80-84,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：四川省妇幼医学科技创新课题重点项目(项目编号:22FXZD01);四川省医学会科研课题(项目编号:S22015);成都市卫生健康委员会科研课题(项目编号:2022155);四川省自然科学基金(项目编号:2023NSFSC0548);院内科技创新基金项目(项目编号:20240312)。

摘　　要：目的探讨不同卵泡输出率(follicular output rate,FORT)的高龄患者体外受精-胚胎移植(in vitro fertilizationand embryo transfer,IVF-ET)结局。方法回顾性分析2017年12月至2022年12月在四川省妇幼保健院生殖医学中心行IVF-ET助孕治疗的603例高龄患者,女方年龄≥35岁,按照FORT值分为3组:低FORT组,FORT位于33%以下者(FORT<50.00%,n=201);中FORT组,FORT位于33%~67%(FORT处于50.00%~83.00%,n=201);高FORT组,FORT位于67%以上者(FORT>83.00%,n=201)。比较3组患者一般情况、超排卵指标、卵母细胞及胚胎质量、胚胎移植结局。结果3组扳机日雌二醇(estrogen,E_(2))水平、孕酮(progesterone,P)水平、获卵数、成熟卵(mature oocytes,MII)数、正常受精卵数、day 3(D_(3))卵裂胚数高FORT组最高,其次为中FORT组,低FORT组最低差异有统计学意义(P<0.05)。高FORT组优质囊胚率明显高于低FORT组(P<0.05)。临床妊娠率、持续妊娠率、活产率高FORT组最高,其次为中FORT组,低FORT组最低,但差异无统计学意义(P>0.05)。结论高龄患者IVF-ET中卵巢高反应有利于卵母细胞及提高胚胎质量,可能有利于IVF-ET结局。Objective To explore the outcomes of in vitro fertilization and embryo transfer(IVF⁃ET)in aged women with different follicle output rate(FORT).Methods Retrospective analysis of 603 aged patients of IVF⁃ET assisted pregnancy treatment in the Reproductive Medicine Center of Sichuan Provincial Maternal and Child Health Hospital from December 2017 to December 2022.The female age≥35 years old,all patients were divided into three groups according to the their FORT value:low FORT group,≤33%quantile(FORT value<50.00%,n=201);medium FORT group,33%~67%quantile,(FORT value equaled to 50.00%~83.00%,n=201);high FORT group,≥67%quantile,(FORT value>83.00%,n=201).The general condition,superovulation index,oocyte and embryo quality,embryo transfer outcome were compared.Results There were statistically significant differences in the levels of estradiol(E_(2)),progesterone(P)on the trigger day,the number of oocytes,mature oocytes,normal fertilized oocytes and day 3(D_(3))cleavage embryos in three groups,highest in the high FORT group,followed by the medium FORT group and the low FORT group(P<0.05).The rate of high⁃quality blastocysts in the high FORT group was significantly higher than that in the low FORT group(P<0.05).The clinical pregnancy rate,sustained pregnancy rate,and live birth rate were highest in the high FORT group,followed by the medium FORT group and the low FORT group,but the difference was not statistically significant(P>0.05).Conclusion High ovarian response in aged women with IVF⁃ET is beneficial for oocyte and improving embryo quality,which may be beneficial for IVF⁃ET outcomes.

关 键 词：高龄 体外受精 胚胎移植 卵泡输出率 

分 类 号：R711.76[医药卫生—妇产科学]