增加启动剂量对年龄相关的卵巢反应性以及临床结局的影响

发布时间：2018-03-09 14:33

本文选题：年龄　切入点：FSH启动剂量　出处：《广东医学》2017年02期 　论文类型：期刊论文

【摘要】：目的比较控制性超排卵中,各年龄段妇女行IVF/ICSI治疗时,选择不同启动剂量的获卵数和临床结局,探讨各年龄段增加启动剂量与获卵数及妊娠结局的关系。方法回顾性分析进行IVF/ICSI第一周期治疗,采用长方案超排卵,第2天或者第3天移植2~3个胚胎的患者共2 853个周期。按年龄≤30岁,31~34岁,35~37岁,≥38岁进行分组,启动剂量按≤150 IU、151~225 IU、225 IU进行分组,并且进一步比较31~34岁组,抗苗勒管激素(AMH)≤1.0 ng/m L时,不同启动剂量间的结局。结果启动剂量分别为≤150 IU、151~225 IU、225 IU时,≤30岁组着床率和妊娠率在≤150 IU组较高,但差异无统计学意义(P0.05)。31~34岁组≤150IU组着床率和妊娠率显著高于151~225 IU组(P0.05),其他无差异(P0.05)。35~37岁组获卵数225 IU组显著低于其他两组(P0.05),而着床率150~225 IU组显著高于225 IU组(P0.05),余无差异(P0.05)。≥38岁组着床率和妊娠率在150~225 IU组较高,但差异无统计学意义(P0.05)。各年龄段内早期流产率随剂量增加而增加,但差异无统计学意义(P0.05)。31~34岁组,AMH≤1.0 ng/m L时,随着启动剂量的增加,获卵数、着床率、妊娠率无明显改善,早期流产率增加,但差异无统计学意义(P0.05)。结论卵巢功能正常的情况下,≤34岁妇女,≤150 IU/d的起始剂量能获得较好的获卵数、着床率和妊娠率,≥35岁妇女,151~225 IU/d的起始剂量能获得较好的获卵数以及着床率和妊娠率。卵巢低反应时,增加启动剂量并不能增加卵巢反应性以及改善妊娠结局。
[Abstract]:Objective to compare the controlled ovarianhyperstimulation, women of all ages for the IVF/ICSI treatment, choose a different starting dose of oocytes and clinical outcomes, to explore the relationship between the age and the number of retrieved oocytes increased starting dose and pregnancy outcome. Methods Retrospective analysis of the first IVF/ICSI cycle therapy with controlled ovarian hyperstimulation, second or third days of transplantation of 2~3 embryos with a total of 2853 cycles. By age less than 30 years, 31~34 years, 35~37 years old, above 38 years old group, starting doses were less than 150 IU, 151~225 IU, IU 225 groups, and further compare the 31~34 age group, anti Mullerian hormone (AMH) is less than or equal to 1 ng/m L, different starting dose between outcomes. Results starting doses were less than 150 IU, 151~225 IU, 225 IU, less than 30 years old group, implantation rates and pregnancy rate is higher in 150 IU group, but the difference was not statistically significant (P0.05).31~34 group than 150IU group of implantation rate and pregnancy rate 151~225 was significantly higher than that of IU group (P0.05), the other is no difference (P0.05).35~37 age group 225 oocytes in IU group was significantly lower than the other two groups (P0.05, 150~225) and the implantation rate of IU group was significantly higher than that of 225 IU group (P0.05), but no difference (P0.05). More than 38 years old group of implantation and pregnancy rates high in 150 ~225 IU group, but the difference was not statistically significant (P0.05). The age of the early abortion rate with the dose increased, but the difference was not statistically significant (P0.05).31~34 age group, AMH = 1, ng/m L, with the increase of the threshold dose, number of oocytes, the implantation rate, pregnancy rate obviously, early abortion rate increased, but the difference was not statistically significant (P0.05). Conclusion the normal ovarian function, less than 34 women aged less than 150 of the initial dose of IU/d can obtain better oocytes and implantation rate and pregnancy rate, more than 35 year old woman, the initial dose of 151~225 IU/d can get better the number of oocytes, the implantation rate and Pregnancy rate. When ovarian response is low, the increase in the start dose does not increase the ovarian responsiveness and improve the pregnancy outcome.

【作者单位】：广州医科大学附属第三医院生殖医学中心广东省生殖医学重点实验室广东省普通高校生殖与遗传重点实验室;河北省计划生育科学技术研究院;
【基金】：广东省中医药管理局建设中医药强省科研课题(编号:20142097) 广州医科大学青年科研项目(编号:2014A18)
【分类号】：R714.8

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