小卵泡穿刺术在控制性促排卵中应用的效果观察

目的：观察在行体外受精-胚胎移植（IVF-ET）控制性促排卵（COS）中，卵泡发育过多的患者应用小卵泡穿刺术后的周期结局。方法：将2011年4月至2012年4月在本中心行IVF-ET促排卵过程中卵泡发育数量过多（促排卵后7～9 d，双侧卵巢卵泡数超过20个）的患者，按其意愿分成2组：小卵泡穿刺组（n=36）和对照组（n=32）。比较2组一般指标、血清性激素水平、卵子发育情况和妊娠率等。结果：2组患者年龄、不孕年限、基础内分泌水平及穿刺日血清卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）差异均无统计学意义（P＞0.05）。小卵泡穿刺组人绒毛膜促性腺激素（hCG）日血清E2水平、获卵数较对照组明显降低；卵子成熟率、卵裂率、优胚率及妊娠率均显著高于对照组，2组比较差异有统计学意义（P＜0.05）。小卵泡穿刺组无中重度卵巢过度刺激征（OHSS）发生，对照组中发生OHSS 13例（占40.6%）。结论：小卵泡穿刺术能有效解决IVF-ET促排卵过程中卵泡发育过多的问题，降低OHSS发生率，改善IVF-ET周期的结局。

Observation on effects of the small follicles puncture using Gn 7-9 days in vitro fertilization cycles

Objective：To observe clinical outcome of the patients with excessive follicular development in controlling ovulation process treating with the small follicles puncture. MethodSixty-four infertile women in our center accepted IVF treatment during the period from April 2011 to April 2012 were analyzed retrospectively. All of them had excessive follicular development and had the tendency of ovarian hyperstimulation syndrome （OHSS）. They were divided into two groups based on the their wills. The follicle puncture group （n=36） and con-trol group （n=32）. The general index, the laboratory and the clinical outcome of the two groups were compared. ResultThere were no statistically signiifcant differences in age, time of infertility, basal and the day of follicles puncture hormones level （P＆gt;0.05）. The day of hCG serum level of estradiol （estrogen, E2） and the number of oocyte retrieved in follicle puncture group was obviously lower than that in control group （P＆lt;0.05）. The rates of fertilization, cleavage, and clinical pregnancy in follicle puncture group was obviously higher than that in control group （P＆lt;0.05）. The follicle puncture group had no severe ovarian hyperstimulation, but the severe OHSS oc-curred in 13 patients （13/32, 40.6%） of control group. Conclusion：The small follicle puncture can effectively reduce the incidence of OHSS and improve the outcome of IVF-ET cycles.