微刺激等全胚冷冻胚胎移植结局分析

目的：比较全胚冷冻后首次冻融胚胎移植中三组不同原因行全胚冷冻患者的临床结局，探讨微刺激促排卵方案对卵巢低反应患者的有效性。方法：回顾性分析2011年10月至2012年3月行全胚冷冻并行冻融移植的患者87例，根据患者行全胚冷冻的指针不同分为微刺激方案组、E2升高组和孕酮（P）升高及其他原因组。比较三组患者年龄、不孕年限、助孕周期、注射Gn天数、使用FSH、HMG用量、获卵数、获得优质胚胎数及妊娠率等是否存在差异。结果：微刺激组患者年龄较其他两组大，差异有统计学意义（P〈0．05）；微刺激组不孕年限及助孕周期较其他两组长，差异无统计学意义（P〉0．05）；微刺激组注射Gn天数少，差异有统计学意义（P〈0．05）；微刺激组FSH用量少而HMG用量多，差异有高度统计学意义（P〈0．01）；微刺激组获卵数较其他两组少，差异有统计学意义（P〈0．05）；微刺激组A级胚胎及B及胚胎较其他两组少，但差异无统计学意义（P〉0．05）；微刺激组冷冻胚胎较其他两组少，差异有统计学意义（P〈0．05）；微刺激组妊娠率低，差异有统计学意义（P〈0．05）。结论：微刺激方案是卵巢低反应患者较理想的促排卵方案。

Clinical outcome of micro - stimulation in frozen - thawed embryo transfer and whole embryo freezing

Objectives： To compare the clinical outcomes of patients who were treated with first frozen -thawed embryo transfer after whole embryo freezing; to explore the how patients with poor ovarian response respond to micro - stimulation. Meth- ods ： We did a retrospective analysis of 87 patients who were treated with whole embryo freezing and frozen - thawed embryo trans- fer October 2011 to March 2012. They were divided into the micro- stimulation group, the high E2 group, the high progesterone group and other reason group according to the indexes of whole embryo freezing. Patients＇ age, infertility duration, assisted repro- ductive cycles, days of Gn injection, FSH and HMG dosage, number of retrieved oocytes, high quality embryos and pregnancy ra- tio of the first three groups were observed and compared. Results： The patients in the micro - stimulation group were statistically significantly older than the patients in other groups （ P 〈 0.05 ）. Infertility duration and assisted reproductive cycles of the micro - stimulation group were longer than those of the other two groups, but the difference was not statistically significant （ P 〉 0.05 ）. Days of Gn injection of the micro - stimulation group were statistically significantly fewer than those of the other two groups （ P 〈 0.01 ）. Number of retrieved oocytes of the micro - stimulation group was statistically significantly fewer than those of the other two groups （ P 〈 0.05 ）. Numbers of A oocytes and B oocytes of the micro - stimulation group were fewer than those of the other two groups, but the difference was not statistically significant （ P 〉 0.05 ）. Number of freezing embryos was statistically significantly lower than that of the other two groups （ P 〈 0.05 ）. Pregnancy ratio of the micro - stimulation group was statistically significantly lower than that of the other two groups （ P 〈 O. 05 ）. Conclusion ： Micro - stimulation is an ideal treatment plan for patients with poor ovarian response.