GnRH激动剂方案适宜获卵数的探讨:9188例新鲜周期胚胎移植回顾性分析

目的探讨IVF-ET治疗中GnRH激动剂方案促排卵的适宜获卵数。方法回顾性分析2014年1月至2015年12月于西北妇女儿童医院生殖中心行IVF/ICSI新鲜周期胚胎移植的患者(共9 188例)的临床资料,以获卵数不同将患者分为5组,分别为获卵1~3枚组、4~7枚组、8~13枚组、14~19枚组、≥20枚组,比较各组患者的基本情况及胚胎发育情况,以及继续妊娠率、周期取消率等临床结局。结果各组患者随着年龄减少,获卵数、双原核(2PN)胚胎数、可用胚胎数及优质胚胎数显著增加(P0.05)。获卵8~13枚组的继续妊娠率显著高于1~3枚组、4~7枚组(P0.05),且其周期取消率显著低于1~3枚组、14~19枚组及≥20枚组(P0.05);其OHSS率亦显著低于14~19枚组及≥20枚组,无可用胚胎率显著低于1~3枚组、4~7枚组(P均0.05)。结论在GnRH激动剂促排卵方案中,获卵数8~13枚时继续妊娠率较高,且周期取消率及OHSS发生率较低,是新鲜周期胚胎移植较适宜的获卵数。

Optimum number of oocytes retrieved with GnRH agonist protocol:Retrospective analysis of 9 188 fresh IVF cycles

Objective: To explore the optimum number of oocytes retrieved with GnRH agonist protocol in IVF-ET. Methods: The data of 9 188 fresh IVF cycles in ART center of Northwest Women's and Children's Hospital from January 2014 to December 2015 were retrospectively analyzed. All the cycles were divided into 5 groups according to the number of oocytes retrieved: group A (1-3 oocytes),group B (4-7 oocytes),group C (8-13 oocytes),group D (14-19 oocytes) and group E (≥20 oocytes). The ongoing pregnancy rate,cycle cancel rate and canceled by OHSS rate were compared among the groups. Results: The number of oocytes retrieved,the number of available embryos & high quality embryos were increased significantly along with the decrease of age of the patients (P<0.05). The ongoing pregnancy rate in group C (54.9%) was significantly higher than group A (33.4%),group B (47.0%) (P<0.05),and the cycle cancellation rate (18.2%) was significantly lower than group A (37.2%),group D (36.6%) and group E (59.0%) (P<0.05). The OHSS rate in group C was significantly lower than group D and E,and the rate of no available embryos was significantly lower than group A and B (P<0.05). Conclusions: The optimum number of oocytes retrieved with GnRH agonist protocol is 8-13 oocytes in fresh IVF cycles due to that the ongoing pregnancy rate is higher and cycle cancelltion rate & OHSS incidence are lower.