CAJ | 학술논문

目的：探讨控制性超促排卵周期中卵巢高反应对卵母细胞、胚胎质量及妊娠结局的影响。方法回顾性分析2012年因输卵管因素和(或)男方因素初次行体外受精-胚胎移植( in vitro fertilization and embryo transfer ,IVF-ET)和卵胞浆内单精子注射( intracytoplasmic sperm injection ,ICSI)周期治疗的259例不孕患者的临床资料。根据绒毛膜促性腺激素( human chorionic gonadotrophin, HCG )注射日血清雌二醇(estradiol,E2)水平及获卵数分为卵巢高反应组(114例)和正常反应组(145例),比较两组卵母细胞和胚胎参数、妊娠结局。结果卵巢高反应组获卵数、MII卵数、优质胚胎数、移植周期取消率和冻胚率均显著高于正常反应组(P<0．05)；MII卵率、受精率、优质胚胎率和种植率均显著低于正常反应组(P<0．05)。两组间卵裂率、临床妊娠率、流产率和中重度卵巢过度刺激综合征( ovarian hyperstimulation syndrome,OHSS)发生率均无统计学差异(P>0．05)。结论卵巢高反应引起的高雌激素环境可能对卵母细胞及胚胎质量造成一定的影响,最终影响到妊娠结局。
목적：탐토공제성초촉배란주기중란소고반응대란모세포、배태질량급임신결국적영향。방법회고성분석2012년인수란관인소화(혹)남방인소초차행체외수정-배태이식( in vitro fertilization and embryo transfer ,IVF-ET)화란포장내단정자주사( intracytoplasmic sperm injection ,ICSI)주기치료적259례불잉환자적림상자료。근거융모막촉성선격소( human chorionic gonadotrophin, HCG )주사일혈청자이순(estradiol,E2)수평급획란수분위란소고반응조(114례)화정상반응조(145례),비교량조란모세포화배태삼수、임신결국。결과란소고반응조획란수、MII란수、우질배태수、이식주기취소솔화동배솔균현저고우정상반응조(P<0．05)；MII란솔、수정솔、우질배태솔화충식솔균현저저우정상반응조(P<0．05)。량조간란렬솔、림상임신솔、유산솔화중중도란소과도자격종합정( ovarian hyperstimulation syndrome,OHSS)발생솔균무통계학차이(P>0．05)。결론란소고반응인기적고자격소배경가능대란모세포급배태질량조성일정적영향,최종영향도임신결국。
Objective To investigate the influence of high ovarian response on quality of oocyte and embryo, pregnancy outcome in IVF/ICSI cycles. Methods A retrospective study was designed covering 259 infertile patients with male and / or tubal factor who were admitted to first IVF / ICSI treatment from January 2012 to December 2012. All cases were divided into high responder group(n=114) and normal responder group(n=145) according to E2 level of HCG day,the oocyte and embryo parameters and pregnancy outcomes were compared between two groups. Results The number of oocytes,MII oocytes,good-quality embryos,the cycle cancellation rate in high responder group were significantly higher than those of normal responder group(P<0. 05),but the MII oocytes rate,fertilization rate,high-grade embryo rate and implantation rate were significantly lower than those of normal responder group (P<0. 05). No significant difference in cleavage rate,pregnancy rate,miscarriage rates and the incidence of moderate and severe ovarian hyperstimulation were found between two groups ( P >0. 05 ) . Conclusion The high ovarian response would affect the quality of oocyte and embryo,pregnancy outcome though high estrogen environment.