不同控制性超排卵方案中的卵泡发育不同步分析

目的:探讨不同控制性超排卵方案中卵泡发育不同步的情况。方法:回顾性分析行IVF/ICSI助孕的不孕症患者1166个周期。按COH方案的不同,分为长方案组(n=1085)、短方案组(n=34)和超长方案组(n=47);另长方案组中再按年龄分为<30岁组(n=429)、30～34岁组(n=421)和≥35岁组(n=235)。将阴道B超监测最大卵泡与次大卵泡相差3mm视为卵泡发育不同步。分析启动Gn日、启动Gn后4d、7d和9d的卵泡发育不同步情况。结果:①启动Gn日卵泡发育不同步率不同COH方案组间无统计学差异;启动Gn4d、7d、9d卵泡发育不同步率短方案组最高,其次为超长方案组,最后为长方案组,但是仅在启动Gn7d时长方案与短方案比较有统计学差异(P<0.05)。②长方案组中不同年龄组比较,启动Gn日卵泡发育不同步率3组间无统计学差异。启动Gn4d、7d、9d卵泡发育不同步率随着年龄的增长而增高,但仅在启动Gn7d时<30岁组与≥35岁组间和启动Gn9d时≥35岁组与另2组间比较有统计学差异(P<0.05)。结论:①长方案较短方案和超长方案卵泡发育更同步;②随着年龄增长卵泡发育不同步逐渐增加。

Analysis of Follicle Developmental Unsynchronization in the Different Protocols of Controlled Ovarian Hyperstimulation

Objective：To study the follicle developmental unsynchronization in the different protocols of controlled ovarian hyperstimulation（COH）.Methods：A total of 1 166 assisted reproductive cycles were prospectively studied from the infertile patiets undergoing IVF/ICSI.The patients were divided into 3 groups by the differentCOH protocols：the long protocolgroup（n=1 085）,the short protocol group（n=34） and the ultralong potocol group（n=47）.The patients in the long protocol group were divided into 3 groups by age：〈30 years old group（n=429）,30-34 years old group（n=421）and≥35 years old group（n=235）.The follicular developmental unsynchronization was regarded when the follicular diameters discrepancies were ≥3 mm.The follicular developmental unsynchronization was analyzed on the day of using gonadotropin（Gn）,4 d,7 d and 9 d after using Gn.Results：1）The follicular developmental unsynchronization rate on the day of using Gn was not significantly different in 3 COH groups.The follicular developmental unsynchronization rate in 4 d,7 d and 9 d after using Gn was highest in the short protocol group,followed by the ultralong protocol,the last for the long protocol.But the follicular developmental unsynchronization rate only in 7 d after using Gn was significantly different between the long protocol group and the short protocol group （P〈0.05）.2）The follicular developmental unsynchronization rate on the day of using Gn was not significantly different in three age groups.The follicular developmental unsynchronization rate in 4 d,7 d and 9 d after using Gn increased with age.But the follicular developmental unsynchronization rate only in 7 d after using Gn was significantly different between the≥35 years old group and〈30 years old group（P〈0.05）.But the follicular developmental unsynchronization rate only in 9 d after using Gn was significantly different between the ≥35 years old group and the other two groups（P〈0.05）.Conclusion：1）The follicular developmental unsynchronization rate in the long protocol of COH is lowest in three groups.2）The follicular developmental unsynchronization rate increased with age.