基础窦状卵泡计数对多囊卵巢综合征患者辅助生殖技术后妊娠结局的影响  

Effect of basal antral follicle count on pregnancy outcome after assisted reproduction in patients with polycystic ovary syndrome

作　　者：陈咏 肖玉红 张倩 何泽平 于月新 CHEN Yong;XIAO Yu-hong;ZHANG Qian;HE Ze-ping;YU Yue-xin(Department of Reproductive Med icine,General Hospital of Northern Theater Command,Shenyang 110003,China)

机构地区：[1]解放军北部战区总医院生殖医学科,辽宁沈阳110003

出　　处：《中国实用妇科与产科杂志》2024年第11期1125-1129,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：2021军委后勤保障部卫生局计生专项科研课题(21JSZ11)。

摘　　要：目的探讨不同基础窦状卵泡计数(AFC)患者辅助生殖技术过程中的不同临床特征,并分析其对妊娠结局的影响。方法纳入2020年5月至2023年1月在解放军北部战区总医院生殖医学科接受辅助生殖技术治疗的多囊卵巢综合征(PCOS)不孕患者,共154例。患者按照基础AFC分为≤22枚(n=63),23~27枚(n=45)以及≥28枚(n=46)3组。所有患者均接受辅助生殖技术治疗。结果不同基础AFC患者的基线血清睾酮、抗米勒管激素(AMH)、卵巢过度刺激综合征(OHSS)风险、新鲜周期取消率等指标,组间差异均有统计学意义(P<0.05)。体外受精后,AFC≥28枚组患者的可利用囊胚数(4.3±0.8)个,均显著大于AFC 23~27枚组的(3.6±0.7)个和AFC≤22枚组的(2.3±0.5)个(P=0.012);AFC≥28枚组的优质囊胚率(44.6±12.2)%均显著高于AFC 23~27枚组的(41.2±5.9)%和AFC≤22枚组(27.8±8.3)%(P=0.041)。胚胎移植后,AFC≥28枚的患者临床妊娠率为80.4%,显著高于AFC 23~27枚组(64.4%)和AFC≤22枚组(57.1%)(P=0.038)。结论基础AFC较多的PCOS不孕患者接受辅助生殖技术治疗后,可用囊胚数、优质囊胚率以及临床妊娠率较高,对妊娠结局具有积极影响。但随着基础AFC增高,OHSS风险和新鲜移植周期取消率也增高,应该注意防治OHSS和新鲜周期取消风险。Objective To study different clinical characteristics of patients with different basal antral follicle count(AFC)during assisted reproduction and to analyze their effect on pregancy outcomes.Methods This study included infertile patients with polycystic ovary syndrome(PCOS)who underwent assisted reproductive therapy in the Department of Reproductive Medicine,General Hospital of Northern Theater Command from May 2020 to January 2023.A total of 154 patients were divided into three groups according to the basic AFC<22(n=63),23-27(n=45)and≥28(n=46).All patients received assisted reproductive treatment.Results There were significant differences in baseline serum testosterone,anti-Mullerian hormone(AMH),ovarian hyperstimulation syndrome(OHSS)risk,and fresh cycle cancellation rate among the three groups(P<0.05).After in vitro fertilization,the number of available blastocysts in AFC≥28 group(4.3+0.8)was significantly higher than that in AFC 23-27 group(3.6±0.7)and AFC<22 group(2.3±0.5)(P=0.012).The highquality blastocyst rate of AFC≥28 group(44.6±12.2)%was significantly higher than that of AFC 23-27 group(41.2±5.9)%and AFC<22 group(27.8±8.3)%(P=0.041).After embryo transfer,the clinical pregnancy rate of patients with AFC≥28 was 80.4%,which was significantly higher than that of AFC 23-27 group(64.4%)and AFC<22 group(57.1%)(P=0.038).Conclusions After assisted reproductive treatment,the number of available blastocysts,high-quality blastocyst rate and clinical pregnancy rate are higher in PCOS infertile patients with more basic AFC,which has a positive impact on pregnancy outcome.However,with the increase of basic AFC,the risk of OHSS and the cancellation rate of fresh transplantation cycle also increase,So attention should be paid to the prevention and treatment of the risk of OHSS and fresh cycle cancellation.

关 键 词：窦状卵泡计数 多囊卵巢综合征 辅助生殖技术 临床妊娠率 

分 类 号：R711.6[医药卫生—妇产科学]