控制性超促排卵过程中扳机日直径≥17 mm卵泡占比对辅助生殖助孕结局的影响  

Impact of the proportion of follicles with a diameter of≥17 mm on trigger day on the pregnancy outcome of assisted reproductive technology during controlled ovarian hyperstimulation

作　　者：王梦迪 李莹星 吕兴钰 Enoch Appiah Adu-Gyamfi 唐晓君[1] 钟朝晖[1] 丁裕斌[1] Wang Mengdi;Li Yingxing;LüXingyu;Enoch Appiah Adu-Gyamfi;Tang Xiaojun;Zhong Zhaohui;Ding Yubin(School of Public Health,Chongqing Medical University;The Reproductive Center,Sichuan Jinxin Xinan Women&Children Hospital)

机构地区：[1]重庆医科大学公共卫生学院,重庆400016 [2]四川锦欣西囡妇女儿童医院生殖医学科,成都610011

出　　处：《重庆医科大学学报》2025年第2期230-236,共7页Journal of Chongqing Medical University

基　　金：重庆市妇幼保健院资助项目(编号:CQFYSJ01001)。

摘　　要：目的:分析扳机日直径≥17 mm卵泡占比(直径≥17 mm卵泡数/直径≥14 mm卵泡数)对辅助生殖患者助孕结局的影响。方法:回顾性分析2018年7月至2023年9月于成都锦欣西囡妇科医院行体外受精/胞浆内单精子注射(in vitro fertilization,IVF/intracytoplasmic sperm injection,ICSI)助孕的3848个周期。每位患者接受卵泡期长效长方案或拮抗剂方案治疗。通过直径≥17 mm卵泡占比分为A、B、C 3组(卵泡期长效长方案:A组:≤60%,B组:61%~73%,C组:>73%;拮抗剂方案:A组:≤62%,B组:63%~75%,C组:>75%),使用多因素logistic回归评估直径≥17 mm卵泡占比是否影响患者的活产率,临床妊娠率和流产率等助孕结局。结果:(1)卵泡期长效长方案:以A组为参考,多因素logistic回归分析结果显示,C组的流产风险是A组的1.700倍(95%CI=1.123~2.576;P=0.012)。此外,未发现直径≥17 mm卵泡占比对患者的活产率、卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)发生率、临床妊娠率的影响。(2)拮抗剂方案:未发现直径≥17 mm卵泡占比与患者助孕结局之间存在关联。结论:对于接受卵泡期长效长方案的患者而言,扳机日直径≥17 mm卵泡占比越高,患者的流产风险越大。对于接受拮抗剂方案治疗的患者而言,未发现直径≥17 mm卵泡占比与不良妊娠结局之间的关联。Objective:To investigate the impact of the proportion of follicles with a diameter of≥17 mm on trigger day(follicles≥17 mm/follicles≥14 mm)on the pregnancy outcome of patients receiving assisted reproductive technology.Methods:A retrospective analysis was performed for the data of 3848 cycles of in vitro fertilization/intracytoplasmic sperm injection for promoting pregnancy in Chengdu Jinxin Xinan Women’s Hospital from July 2018 to September 2023,and the patients received the long-acting long regimen or the antagonist regimen in the follicular phase.According to the proportion of follicles with a diameter of≥17 mm,the patients were divided into groups A,B,and C(the long-acting long regimen:≤60%for group A,61%-73%for group B,and>73%for group C;the antagonist regimen:≤62%for group A,63%-75%for group B,and>75%for group C).A multivariate logistic regression analysis was used to assess the impact of the proportion of follicles with a diameter of≥17 mm on the pregnancy outcomes of patients,including live birth rate,clinical pregnancy rate,and miscarriage rate.Results:As for the long-acting long regimen in the follicular phase,the multivariate logistic regression analysis showed that the risk of miscarriage in group C was 1.700 times that in group A(95%CI=1.123~2.576,P=0.012),and in addition,the proportion of follicles with a diameter of≥17 mm had no impact on live birth rate,the incidence rate of ovarian hyperstimulation syndrome,or clinical pregnancy rate.As for the antagonist regimen,no association was found between the proportion of follicles with a diameter of≥17 mm and the pregnancy outcomes of the patients.Conclusion:For the patients receiving the long-acting long regimen in the follicular phase,the risk of miscarriage increases with the increase in the proportion of follicles with a diameter of≥17 mm on trigger day,while for the patients receiving the antagonist regimen,no association is found between the proportion of follicles with a diameter of≥17 mm on trigger day and adverse pregnanc

关 键 词：直径≥17 mm卵泡占比 卵泡直径 卵泡期长效长方案 拮抗剂方案 辅助生殖 助孕结局 

分 类 号：R173[医药卫生—妇幼卫生保健]