小于37岁女性卵巢储备下降患者卵子质量及临床妊娠结局

发布时间：2018-06-15 21:32

本文选题：卵巢储备功能下降 + 年轻妇女　；参考：《实用医学杂志》2017年03期

【摘要】：目的:探讨37岁年轻女性卵巢储备功能下降(DOR)不孕妇女IVF/ICSI助孕周期卵子和胚胎的数量、质量及临床妊娠结局。方法:回顾性分析我中心4 251例不孕症患者,按年龄、卵巢储备情况分组,其中年轻正常储备1 683例,年轻DOR 1 005例,年老DOR 1 563例,比较3组一般情况、获卵数、卵子及胚胎质量、促排周期结局及临床结局的差异。结果:年轻DOR组正常受精率65.80%,优质胚胎形成率42.36%,较年老DOR组高(44.95%vs.29.07%,P0.01),但仍低于年轻卵巢正常储备组(78.86%vs.56.42%,P0.01);周期取消率、未获卵周期率、无可利用胚胎周期率与年老DOR组相当,明显高于年轻正常卵巢储备组。年轻DOR组生化妊娠率46.67%,临床妊娠39.05%,胚胎种植率28.49%,均高于年老DOR组,但低于年轻卵巢正常储备组;流产率20.73%,虽低于年老DOR组(36.92%),但显著高于年轻卵巢正常储备组(20.73%);3组宫外孕率差异无统计学意义。结论:37岁年轻DOR患者虽卵巢低反应、获卵数、胚胎数减少,但一旦获卵仍有较高几率获得优质胚胎及较好的临床妊娠率。对该类患者应放宽IVF/ICSI指征,积极给予相应治疗。
[Abstract]:Objective: to investigate the quantity, quality and clinical pregnancy outcome of IVF / ICSI assisted IVF / ICSI cycles in infertile women aged 37 years. Methods: 4 251 infertile patients in our center were divided into three groups according to age and ovarian reserve, including 1 683 young normal reserve, 1 005 young DOR and 1 563 old DOR. Differences in egg and embryo quality, cycle outcome and clinical outcome. Results: the normal fertilization rate and the embryo formation rate of the young DOR group were 65.80 and 42.36, which were higher than those of the old DOR group (44.95vs.29.07p0.01), but still lower than that of the young ovarian normal reserve group (78.86vs.56.42), the cycle cancelling rate, the rate of unobtained egg cycle, and the rate of unexploited embryo cycle were equal to those of the old DOR group. It was significantly higher than that in the young normal ovarian reserve group. The biochemical pregnancy rate, clinical pregnancy rate and embryo implantation rate in young DOR group were 46.67 and 39.05, respectively, which were higher than those in old DOR group, but lower than those in young ovarian normal reserve group. The abortion rate (20.73) was lower than that in the aged DOR group (36.92), but it was significantly higher than that in the young ovarian normal reserve group (20.73). There was no significant difference in the ectopic pregnancy rate among the three groups. Conclusion although the ovarian response is low, the number of eggs and the number of embryos are decreased in the young DOR patients aged 37 years old, but there is still a higher chance of obtaining high quality embryos and a better clinical pregnancy rate once the eggs are obtained. IVF / ICSI should be relaxed and treated actively.
【作者单位】：中山大学附属第六医院生殖中心;
【分类号】：R714.8

【相似文献】