35岁以下患者长方案促排卵获卵数对体外受精-胚胎移植结局的影响

摘要

目的 探讨体外受精-胚胎移植(IVF-ET)周期最佳获卵数及其对妊娠结局的影响.方法 回顾性分析我院2009年9月至2010年8月35岁以下行长方案IVF-ET治疗的544个获卵周期的资料.比较不同获卵数的受精率、卵裂率、优胚率、临床妊娠率及并发症等指标的差异.结果 不同获卵数各组间促性腺激素(Gn)刺激天数、Gn用量、卵裂率、优胚率无明显差别(P>0.05),获卵数>25个组受精率低于其他各组(P<0.05).随获卵数的增加,冷冻胚胎数、注射人绒毛膜促性腺激素(hCG)日血雌二醇(E2)值及卵巢过度刺激综合征(OHSS)发生率增加,差异有统计学意义(P<0.05).临床妊娠率随获卵数增加逐渐增加,当获卵数>15个,临床妊娠率较前下降,累积妊娠率随获卵数增加而增加,当获卵数>25个,临床妊娠率和累积妊娠率明显下降.结论 获得适量的卵有利于获得较满意的妊娠结局.%Objective: To explore the effect of retrieved oocyte number on pregnancy outcome of in vitro fertilization and embryo transfer (IVF-ET).Methods: A retrospective analysis was carried out on 544-oocyte pick up(OPU) cycles in women under 35 years old with long protocol IVF-ET in the hospital from Sep 2009 to Aug 2010. The women were divided into 6 groups according to retrieved oocyte number: Group A (≤5 oocytes), Group B (6-10 oocytes), Group C (11-15 oocytes), Group D (16-20 oocytes), Group E (21-25 oocytes), Group F(＞25 oocytes). The fertilization rate, cleavage rate, advanced embryo rate, clinical pregnancy rate, accumulated clinic pregnancy rate, complications etc. in 6 groups were analyzed.Results: The gonadotropin doses, gonadotropin days, cleavage rate or advanced embryo rate showed no statistical difference in women withdifferent number of retrieved oocytes (P＞0. 05). The fertilization rate in the Group F was less than that in other groups (P＜0.05). The frozen embryo number, the serum E2 level and ovarian hyperstimulation syndrome rate were raised with number retrieved oocytes increased.The clinical pregnancy rate enhanced with the retrieved oocyte number increased in ≤15 oocytes of groups,while decreased in ＞15 oocytes of groups. The accumulated pregnancy rate enhanced with retrieved oocyte number increased in ≤25 oocytes of groups, while decreased in ＞25 oocytes of group.Conclusions: Moderate retrieved oocyte number may be coincident optimal clinic pregnancy rate and accumulated clinic pregnancy rate in long protocol IVF-ET.