以卵泡输出率为指标评估植入前遗传学诊断周期的卵巢反应性和临床结局

目的：探讨卵泡输出率（FORT）对进行植入前遗传学诊断（PGD）患者卵巢反应性及临床结局的预测效力。方法：回顾性分析2012年1月-2016年4月在南京医科大学第一附属医院生殖医学科因染色体异常行长方案控制性促排卵治疗的PGD助孕患者共158例。统计所有患者月经来潮第3天计数窦卵泡数（AFC）、人绒毛膜促性腺激素（hCG）治疗日B超计数排卵前卵泡数（PFC），计算FORT，按照FORT大小排序分为高、低2个FORT组（各79例），比较2组获卵数、可移植胚胎数、优质胚胎率及囊胚形成率。结果：高FORT组的获卵数、可移植胚胎数显著高于低FORT组（P＜0.05），但2原核（2PN）受精率、优质胚胎率及囊胚形成率等指标差异无统计学意义（P＞0.05）。结论：FORT可有效地预测辅助生殖技术PGD周期中获卵数及可移植胚胎数，但不能预测胚胎发育潜能。FORT可作为PGD周期常规控制性促排卵治疗过程中预测卵巢反应的一项可靠指标。

Prediction of PGD Outcome Based on the Follicular Output Rate

Objective:To evaluate the follicular output rate (FORT) as a prognostic indicator of response to ovarian and the reproductive competence after PGD.Methods:A total of 158 PGD patients who underwent controlled ovarian stimulation using a long protocol were retrospectively studied.FORT was calculated as the ratio of preovulatory follicle count on the day of stimulation×100/small antral follicle count (3-10 mm in diameter) at baseline.Patients were divided into 2 groups:the low FORT group (79 women) and the high FORT group (79 women).The response of ovarian and IVF-ET pregnancy outcome were analyzed.Results:Among 158 PGD cycles,the numbers of retrieved oocytes and embryos available for transfer in the high FORT group were significantly higher than those in the low FORT group (P＜0.05).However,there were no significant differences in the 2PN fertility rate,good-quality embryos rate and blastocyst formation rate between two groups (P＞0.05).Conclusions:FORT can be used as a index to predict effectively the number of oocytes retrieved and the number of embryos for transfer in the PGD cycle,but it cannot predict the developmental potential of the embryo.