年轻女性长方案获卵数与临床结局的关系

发布时间：2018-04-08 22:15

本文选题：体外受精-胚胎移植(IVF-ET)　切入点：长方案　出处：《生殖与避孕》2015年07期

【摘要】：目的:探讨年轻、卵巢储备正常女性黄体期长方案中最佳获卵数范围,以取得最佳的临床结局。方法:回顾性分析首次接受体外受精-胚胎移植(IVF-ET)且卵巢储备正常的1 526例患者的临床资料。根据获卵数不同分为5组:A组(4~6枚)、B组(7~9枚)、C组(10~12枚)、D组(13~15枚)、E组(≥16枚),比较各组的受精率、卵裂率、种植率、可移植胚胎数、早期流产率、临床妊娠率及活产率、因卵巢过度刺激综合征(OHSS)倾向全部胚胎冷冻率、无可利用胚胎取消周期率和累积妊娠率及活产率等。结果:1各组受精率、卵裂率、无可利用胚胎取消率、种植率及早期流产率无统计学差异(P0.05)。新鲜周期移植临床妊娠率及活产率C组最高,但差异无统计学意义(P0.05)。2随着获卵数的增加,可利用胚胎数增加,因OHSS倾向全部胚胎冷冻率显著增加。可利用胚胎率E组显著低于其他4组,D组显著低于B组(P0.05)。累积妊娠率及累积活产率A组显著低于C组、D组及E组,B组显著低于E组,差异均具有统计学意义(P0.05)。3 E组全部胚胎冷冻后首次复融移植临床妊娠率显著高于新鲜移植周期(P0.05)。结论:行黄体期长方案促排卵的年轻患者,获卵数为10~12枚时,在获得理想妊娠结局的同时,能够降低OHSS的风险,是理想的获卵数范围。当获卵数≥16枚时,全部胚胎冷冻后择期行复融移植能够取得更理想的临床结局。
[Abstract]:Objective: to investigate the optimal range of egg count in the long luteal phase plan of young women with normal ovarian reserve and to obtain the best clinical outcome.Methods: the clinical data of 1,526 patients with normal ovarian reserve were retrospectively analyzed.Due to ovarian hyperstimulation syndrome (OHSS), the rate of embryo cryopreservation, the rate of embryo cancellation, the rate of cumulative pregnancy and the rate of live delivery were not available.Results there was no significant difference in fertilization rate, cleavage rate, embryo cancellation rate, implantation rate and early abortion rate among different groups (P 0.05).The clinical pregnancy rate and live delivery rate of fresh cycle transplantation were the highest in group C, but there was no significant difference between them. With the increase of egg count, the number of available embryos increased, because OHSS tended to increase the freezing rate of all embryos.The available embryo rate in group E was significantly lower than that in group D and group B significantly lower than that in group B.The cumulative pregnancy rate and cumulative live delivery rate in group A were significantly lower than those in group C, group D and group E were significantly lower than those in group E, and the difference was statistically significant. The clinical pregnancy rate of all embryos in group E after cryopreservation was significantly higher than that in group A (P 0.05).Conclusion: for young patients with ovulation induced by long luteal phase protocol, when the number of eggs is 10 or 12, the ideal pregnancy outcome can be obtained, and the risk of OHSS can be reduced at the same time, which is the ideal range of egg acquisition.When the number of eggs was more than 16, a better clinical outcome could be obtained after cryopreservation of all embryos.
【作者单位】：郑州大学人民医院;河南省人民医院;
【基金】：郑州市科技创新团队项目,项目号为13PCXTD435
【分类号】：R714.8

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