生殖医学杂志2018，Vol.27Issue(1)：5-10,6.DOI:10.3969/j.issn.1004-3845.2018.01.002
卵巢储备功能减退患者新鲜移植周期结局分析
Analysis of IVF outcomes in patients with decreased ovarian reserve function
摘要
Abstract
Objective:To investigate the possible factors affecting the clinical outcome of fresh transplantation cycle in IVF in the patients with ovarian reserve dysfunction(DOR).Methods:The data of 251 controlled ovarian stimulation cycles were retrospectively analyzed.According to ovulation protocol and age,the patients were divided into four groups:105 patients with long protocol & 53 patients with short protocol in the patients less than 35 years;37 patients with long protocol and 56 patients with short protocol in the patients over 35 years.The basic FSH levels,number of antral follicle,response of ovarian stimulation,endometrial thickness,outcome of ovulation induction and pregnancy were compared among the groups.The clinical pregnancy outcomes were also compared between D3 cleavage stage embryo group and D5 blastocyst stage embryo group.Results:In the patients less than 35 years,endometrial thickness [(12.20±2.39)vs.(11.27±2.42)mm],the numbers of oocytes retrieval [(6.50 ± 2.75) vs.(4.8 ± 2.48)],fertilization [(5.02 ± 2.43) vs.(3.74± 2.19)],cleavage[(4.92±2.41) vs.(3.64±2.16)],high-quality embryos [(1.97± 1.86) vs.(1.23±1.38)],and frozen embryos [(1.18 ± 1.54)vs.(0.60±1.08)] in long protocol were significantly higher than those in short protocol(P＜0,05).In the patients over 35 years,the number of fertilization in long protocol was significantly higher than short protocol [(4.92 ± 2.27) vs.(3.86 ± 2.06)] (P＜ 0.05).Between the two age group,there were no statistical differences in the implantation rate,clinical pregnancy rate,abortion rate(P＞0.05).Comparison of different age groups in same protocol,the total amount of gonadotropin(Gn)used was significantly higher [(3 184.30±1 262.12)vs.(3 878.03± 1 466.53)U](P＜20.05),and the numbers of oocytes retrieval,fertilization,cleavage,frozen embryos were reduced,but no significant difference(P＞0.05)along with the increase of age in long protocol.There were no significant differences in the clinical parameters in short protocol(P＞0.05).There were no significant differences in embryo implantation rate,clinical pregnancy rate and abortion rate between the short protocol and long protocol for each age group and between the younger group and the elder group in each protocol group(P＞0.05).There was no significant difference in the clinical outcome between transplanted D3 cleavage stage embryo and D5 blastocyst stage embryo(P＞0.05).Conclusions:The long-term protocol might be more beneficial in improving ovulation outcomes for DOR patients.The clinical outcomes tended to decrease with increasing age in DOR patients.It is recommended to choose high-quality embryo transfer at the time of cleavage when the number of oocytes retrieval is low.关键词
卵巢储备功能减退/控制性促排卵/年龄/妊娠结局Key words
Diminished ovarian reserve/Controlled ovarian hyperstimulation/Age/Pregnancy outcome引用本文复制引用
朱静,周怡然,陈蓓丽,曹云霞..卵巢储备功能减退患者新鲜移植周期结局分析[J].生殖医学杂志,2018,27(1):5-10,6.基金项目
安徽省高校自然科学研究项目重点项目(KJ2016A320) （KJ2016A320）
