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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(P>0.05)。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(P>0.05)。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(P<0.05)。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(P<0.05)。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(P<0.05)。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。
OBJECTIVE: To explore the optimal range of number of oocytes in the young female ovarian normal female luteal phase long-term program to obtain the best clinical outcome. Methods: The clinical data of 1 526 patients who underwent IVF-ET and had normal ovarian reserve were retrospectively analyzed. According to the number of oocytes retrieved, they were divided into 5 groups: group A (4-6), group B (7-9), group C (10-12), group D (13-15), group E 16). The fertilization rate, cleavage rate, implantation rate, number of transplantable embryos, early miscarriage rate, clinical pregnancy rate and live birth rate of all groups were compared. The ovarian hyperstimulation syndrome (OHSS) No available embryo cancellation cycle rate and cumulative pregnancy rate and live birth rate and so on. Results: 1 There was no significant difference in fertilization rate, cleavage rate, abolished embryo ablation rate, implantation rate and early abortion rate in each group (P> 0.05). The clinical pregnancy rate and live birth rate of fresh cycle transplantation were the highest in C group, but the difference was not statistically significant (P> 0.05). 2 As the number of oocytes retrieved increases, the number of available embryos increases, as the tendency of OHSS to all embryo freezing rates increases significantly. The available embryo rate of E group was significantly lower than the other 4 groups, D group was significantly lower than that of B group (P <0.05). The cumulative pregnancy rate and cumulative live birth rate in group A were significantly lower than those in group C, group D and group E, and group B was significantly lower than group E (P <0.05). The clinical pregnancy rate of all 3F group after initial embryo fusion was significantly higher than that of fresh transplantation group (P <0.05). CONCLUSIONS: Young patients with long luteal phase ovulation induction have 10-12 oocytes, which can reduce the risk of OHSS while obtaining the ideal pregnancy outcome. It is the ideal range of oocyte number. When the number of oocytes obtained is more than or equal to 16, all the embryos frozen after elective grafting can achieve a more satisfactory clinical outcome.