不同卵巢储备功能的EMS患者行IVF-ET方案的选择

目的：了解不同卵巢储备功能的子宫内膜异位症( EMS)患者行不同方案的体外受精-胚胎移植( IVF-ET)治疗的结局差异。方法回顾性分析行IVF-ET治疗的337例EMS患者资料。据卵巢储备功能及治疗方案差异分为 A1组(卵巢储备功能正常，超长方案)、A2组(卵巢储备功能正常，长方案)和B1组(卵巢储备功能低下，超长方案)、B2组(卵巢储备功能低下，短方案)，比较各组妊娠结局。结果A1组较A2组、B1组较B2组的获卵数、成熟卵母细胞数、受精数、卵裂数、可移植胚胎数及优质胚胎数均低(P<0．05)，但卵裂率、可移植胚胎率及优胚率的差异均无统计学意义；A1组新鲜周期及解冻周期胚胎着床率、生化妊娠率、临床妊娠率及活产率均较A2组低( P<0．05)，但B1组与B2组新鲜周期及解冻移植( F-ET)周期胚胎着床率、生化妊娠率、临床妊娠率及活产率的差异均无统计学意义。结论采取长方案取卵后行胚胎冷冻、治疗EMS后行F-ET是卵巢储备功能正常的EMS不孕患者IVF-ET最佳方案。

The best IVF-ET protocals of EMS patients with normal and low ovarian reserve function

Objective To compare the outcomes of in vitro fertilization-embryo transfer ( IVF-ET) between endo-metriosis ( EMS) patients with different ovarian reserve function treated by different protocols. Methods A retro-spective clinical analysis of 337 EMS patients undergoing IVF-ET. According to ovarian reserve and protocol, these cases were divided into group A1 ( normal ovarian reserve, super prolonged protocol) , group A2 ( normal ovarian reserve, prolonged protocol) , group B1 ( poor ovarian reserve, super prolonged protocol) and group B2 ( poor o-varian reserve, short protocol) . Then we compared the outcomes. Results The number of retrieved oocytes, MII oocytes, fertilization, cleavage, transferable embryos and high quality embryos were larger in group A2 than group A1, group B2 than group B1 (P<0. 05). But there was no statistical difference in the cleavage rate, transplanted embryo rate and high quality embryo rate. The implantation rate, biochemical pregnancy rate, clinical pregnancy rate and live birth rate in fresh cycles and thawing cycles were higher in group A2 than group A1 ( P<0. 05 ) , but they showed no statistical difference between group B1 and group B2 . Conclusion Prolonged protocol is the opti-mal IVF-ET therapy in EMS patients with normal reserve.