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目的:分析体外受精-胚胎移植(IVF-ET)失败后进行重复治疗周期的妊娠结果。方法:回顾性分析了2006～2008年我院生殖中心进行的702个重复IVF-ET周期(503例),其中先前失败周期在外院和在本院进行的分别有191个(A组)和511个周期(B组)。分析其妊娠结果与重复周期的次数和患者年龄的关系。结果:A组先前失败周期为1次、2次和2次以上在我中心行重复IVF-ET的临床妊娠率无明显差异(56.56%vs66.67%vs61.54%);2次以上失败后的重复周期获卵数显著减少(4.86±2.96vs8.51±4.60vs8.48±3.32),其基础促卵泡生成素(FSH)水平(mIU/ml)显著增高(11.58±11.40vs7.31±3.66vs6.83±2.35)。B组先前失败周期为1次、2次和2次以上的重复周期与本中心首次IVF周期的临床结果比较显示:先前1次失败周期的临床妊娠率、获卵数、移植胚胎数和流产率与本中心首次IVF周期无显著差异;先前2次失败周期的注射绒毛膜促性腺激素(hCG)日E2水平(pg/ml)显著降低(2396.87±1602.02vs4061.17±2255.63),获卵数显著减少(6.66±4.58vs9.59±4.30);先前2次以上失败周期的临床妊娠率、获卵数、内膜厚度和基础FSH水平均显著降低。B组中女方年龄<38周岁的先前失败<3次的患者,其重复周期妊娠率和种植率无明显降低,但先前失败3次以上者的妊娠率和种植率显著降低;女方年龄>38周岁,1～4次的妊娠率、种植率均明显降低。结论:IVF-ET重复周期的妊娠结果与周期次数无相关性,可能与不同中心对患者的治疗有直接相关。同一中心IVF-ET3次以内,妊娠率与周期次数无明显关系,4次以上妊娠率明显下降;年龄可以影响重复周期的结果,超过38岁,妊娠率、种植率下降。
OBJECTIVE: To analyze the pregnancy outcome of repeat treatment cycles after failure of in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 702 repeated IVF-ET cycles (503 cases) performed in our hospital from 2006 to 2008 were retrospectively analyzed. Among them, 191 (group A) and 511 Cycle (Group B). The relationship between the pregnancy outcome and the number of repetitive cycles and patient’s age was analyzed. Results: There was no significant difference in the clinical pregnancy rate of repeat IVF-ET between the two groups (56.56% vs66.67% vs61.54%) in group A with previous failure cycles of 1, 2 or more times. After more than 2 times of failure (4.86 ± 2.96 vs 8.51 ± 4.60 vs 8.44 ± 3.32) and the basal follicle stimulating hormone (FSH) levels (mIU / ml) were significantly increased (11.58 ± 11.40 vs 7.31 ± 3.66 vs6.83 ± 2.35). Comparing the previous failure cycles of Group B with 1, 2, and 2 repeat cycles to the first IVF cycle of our center showed that the clinical pregnancy rate, the number of oocytes retrieved, the number of embryos transferred and the abortion rate in the previous failure cycle There was no significant difference in the first IVF cycle between the two groups. The E2 level (pg / ml) in the two failed cycles was significantly lower (2396.87 ± 1602.02 vs 4061.17 ± 2255.63) (6.66 ± 4.58 vs9.59 ± 4.30). The clinical pregnancy rate, number of oocytes retrieved, intima-media thickness and basal FSH level in the previous failure cycles were significantly decreased. Patients in group B, who had less than 3 previous failures <38 years of age, had no significant reduction in repeat pregnancy rates and implantation rates, but had significantly fewer pregnancies and implants than those previously treated more than 3 times. Women aged 38 years or older , 1 to 4 times the pregnancy rate, implantation rate were significantly lower. CONCLUSION: There is no correlation between pregnancy outcome and number of cycles in IVF-ET repeat cycles, which may be directly related to the treatment of patients in different centers. The same center of IVF-ET3 times less pregnancy rate and the number of cycles no significant relationship, more than 4 times the pregnancy rate decreased significantly; age can affect the results of repeated cycles, more than 38 years of age, pregnancy rate, implantation rate decreased.