辅助生殖技术治疗周期中单侧卵巢对超促排卵及妊娠的影响

目的了解辅助生殖技术(ART)治疗周期中单侧卵巢对超促排卵效果及临床结果的影响.方法对2001年1月～2003年12月3 a内在湘雅医院生殖医学中心接受ART治疗的30个单侧卵巢病例进行分析,了解ART周期治疗前单侧卵巢切除的原因,比较单侧与双侧卵巢患者超促排卵后获卵数及注射HCG日E2水平、植入率及临床妊娠率的差异.结果ART治疗前手术切除一侧卵巢的原因以卵巢病变及宫外孕为主,且单侧卵巢超促排卵后促性腺激素(Gn)用量、用药时间、受精率、卵裂率及妊娠率与双侧卵巢比较差异无显著性(P＞0.05),而注射HCG日E2水平及获卵数较双侧卵巢为低(P＜0.01).结论ART周期中单侧卵巢行IVF-ET时虽临床妊娠率与双卵巢无差异,但注射HCG日E2水平及获卵数低于双侧卵巢,因此对良性卵巢病变生育前应尽量采取保守性手术.

Influence of one ovary on superovulation and clinical pregnancy in ART cycles

Objective To investigate the influence of one ovary on superovulation and clinical pregnancy. [Method] A retrospective analysis was performed on 30 ART cycles with one ovary from January 2001 to December 2003. The etiology of unilateral oophorectomy before ART cycles was estimated. The outcome of superovulation and pregnancy rate were compared between one ovary and two ovaries groups. [Result] Ovarian diseases and ectopic pregnancy were the main causes of unilateral oophorectomy before ART cycles. The doses and duration of gonadotropin, the fertilization rate and clinical pregnancy rate were not statistically different between one ovary and two ovaries groups (P >0.05). But there were significant difference in oocytes recovery between one ovary and two ovaries groups. The mean 17beta-estradiol levels on day of HCG in one-ovary patients were significantly lower compared to two-ovaries (P <0.01). [Conclusion] One-ovary has no influence on clinical pregnancy in ART cycles. But significantly fewer oocytes are recovered from one-ovary patients and the mean 17beta-estradiol levels on day of HCG injection are significantly lower compared to two-ovaries patients. Unilateral oophorectomy should be avoided before child-bearing in ovarian benign diseases.