卵巢储备功能下降患者常规体外受精多精受精发生的影响因素分析OACSTPCD
Factors associated with occurrence of polyspermy during routine IVF in patients with diminished ovarian reserve
目的 探讨卵巢储备功能下降(DOR)人群行常规体外受精(IVF)过程中多精受精发生的影响因素.方法 本研究为回顾性病例对照分析.收集2020年9月至2023年5月在山西省运城市中心医院生殖医学科接受IVF治疗的399例DOR患者(共399个周期)的临床资料.按照本周期是否发生多精受精,分为正常受精组(272个周期)和多精受精组(127个周期),比较两组患者的基本情况及促排卵情况,并采用Logistic回归模型分析多精受精的相关影响因子.结果 纳入研究的DOR患者IVF周期的多精受精发生率为31.83％(127/399).正常受精组和多精受精组间女方年龄、不孕年限、不孕类型、基础窦卵泡数(AFC)及促性腺激素(Gn)启动剂量比较均无显著性差异(P＞0.05);多精受精组的肥胖人群占比、Gn天数、Gn总量、扳机日E2和孕酮水平以及获卵数均显著高于正常受精组(P＜0.05),扳机日LH水平则显著低于正常受精组(P＜0.05).Logistic回归分析表明:Gn天数、Gn总量、扳机日E2、LH和孕酮水平对多精受精的发生无显著影响(P＞0.05);而女性体质量指数(BMI)和获卵数对多精受精的发生有显著影响(相关统计数据分别为OR=2.858,P=0.020;OR=1.634,P=0.000).结论 女性BMI和获卵数是DOR人群中IVF周期多精受精发生的独立危险因素.肥胖的DOR患者在IVF助孕治疗过程更容易出现多精受精的情况.
Objective:To explore the influence factors of polyspermy during routine IVF in the patients with diminished ovarian reserve(DOR). Methods:This study was a retrospective case control analysis.The clinical data of 399 patients with DOR(399 cycles)who received IVF treatment at the Reproductive Medicine Department of Yuncheng Central Hospital in Shanxi Province from September 2020 to May 2023 were collected.According to whether polyspermy occurred in this cycle,the patients were divided into normal fertilization group(272 cycles)and polyspermy fertilization group(127 cycles).The basic date and controlled ovarian hyper-stimulation date of two groups were compared,and then the relevant factors of polyspermy were analyzed by the logistic regression model. Results:The incidence of polyspermy fertilization cycles in the IVF cycle of DOR patients was 31.8％(127/399).There were no differences in female age,infertility duration,infertility type,basal antral follicle count(AFC)and gonadotropin initiation dosage between the normal fertilization group and the polyspermy fertilization group(P＞0.05).Compared to those in the normal fertilization group,the proportion of obese population,duration and total dosage of gonadotropin(Gn)used,estradiol(E2)and progesterone(P)levels on trigger day,as well as the number of retrieved oocytes in the polyspermy fertilization group were significantly higher(P＜0.05).The LH levels on trigger day in the polyspermy group were significantly lower than those in the normal fertilization group(P＜0.05).The results of Logistic regression showed that the days and total dosage of Gn used,the levels of E2,LH and progesterone on the trigger day had no significant impact on the occurrence of polyspermy fertilization(P＞0.05).However,the female BMI levels and the number of oocytes retrieved had a significant impact on the occurrence of polyspermy fertilization(OR=2.858,P=0.020;OR=1.634,P=0.000,respectively). Conclusions:BMI and the number of oocytes retrieved are independent risk factors affecting polyspermy fertilization in IVF treatment for the patients with DOR.Obese DOR patients are more likely to experience polyspermy during IVF treatment
贾瑶;孙亚婷;张露云;王佳;常江璇;朱爱珍
山西省运城市中心医院生殖医学科,运城 044000
临床医学
体外受精多精受精卵巢储备功能下降
In vitro fertilizationPolyspermyDiminished ovarian reserve
《生殖医学杂志》 2024 (001)
17-22 / 6
山西省卫生健康委科研课题(2022054)
评论