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目的分析常规体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)周期中不同卵巢反应性与临床结局的关系。方法回顾性分析2008-2009年在本生殖中心行常规IVF-ET治疗的414例患者资料,按获卵数不同分为卵巢低反应组(获卵数≤5个,n=79)、正常反应组(6～15个,n=239)及高反应组(≥16个,n=96),对临床结局与获卵数、年龄、用药、激素水平、受精率及优胚率等参数的相关性进行分析。结果低反应组的临床妊娠率(25.3%)明显低于正常反应组(41.4%)及高反应组(43.8%)(P<0.05),而周期取消率(20.0%)明显高于正常反应组(2.9%)和高反应组(5.2%)(P<0.05)。临床结局与年龄、获卵数、ET日内膜厚度及ET优胚数显著相关(r分别为-0.145、0.150、0.141、0.215,P<0.01),卵巢低反应组与其他组间年龄、HCG日的E2、LH、ET日E2、P/E2比值、2PN数、胚胎数、优胚数等差异均有统计学意义(P<0.01,P<0.05)。结论卵巢反应性(获卵数)与临床结局密切相关,而年龄是影响获卵数的重要因素,提高卵巢反应性有助于提高临床妊娠率。
Objective To analyze the relationship between different ovarian reactivity and clinical outcome in the conventional cycle of in vitro fertilization-embryo transfer (IVF-ET). Methods The data of 414 patients who underwent conventional IVF-ET in our reproductive center during 2008-2009 were retrospectively analyzed. According to the number of oocytes retrieved, the patients were divided into low ovarian response group (≤5 oocytes, n = 79), normal reaction (6 ~ 15, n = 239) and high response group (≥16, n = 96). The correlation between clinical outcome and number of oocytes, age, medication, hormone level, fertilization rate and excellent embryo rate Sex analysis. Results The clinical pregnancy rate (25.3%) in the low response group was significantly lower than that in the normal response group (41.4%) and the high response group (43.8%) (P <0.05), while the cancellation rate (20.0% (2.9%) and high response group (5.2%) (P <0.05). The clinical outcome was significantly correlated with age, number of oocytes retrieved, ET endometrial thickness and number of ET embryos (r = -0.145,0.150,0.141,0.215, P <0.01, respectively). There were no significant differences in age, HCG The differences of E2, P / E2 ratio, 2PN number, embryo number and excellent embryo number on E2, LH and ET days were statistically significant (P <0.01, P <0.05). Conclusion Ovarian reactivity (number of oocytes retrieved) is closely related to clinical outcome, while age is an important factor affecting the number of oocytes retrieved. Improving ovarian response may help to improve clinical pregnancy rate.