畸胎瘤术后卵巢储备功能正常患者辅助生殖治疗过程及结局分析

目的探讨畸胎瘤及其手术治疗对辅助生殖治疗过程及结局的影响。方法回顾性分析2012年1月至2015年12月在我院生殖医学中心行体外受精胚胎移植/卵胞浆内单精子注射技术(IVF/ICSI)助孕的畸胎瘤术后患者70例(A组),对照组为输卵管积水术后不孕患者78例(B组),对两组患者的一般情况、首次超促排卵过程及妊娠结局进行比较。结果畸胎瘤术后患者与对照组间的取卵周期促性腺激素用量、获卵数、正常受精率、卵裂率及有效胚胎数差异均无统计学意义(P0.05)。两组间的鲜胚周期临床妊娠率、着床率、流产率亦无显著性差异(P0.05)。对照组冻胚移植周期临床妊娠率(82.14%)、着床率(64.71%)均显著高于A组(58.14%,37.50%)(P0.05),而两组间累计临床妊娠率差异无统计学意义(P0.05)。结论卵巢储备功能正常的畸胎瘤剥除术后患者所获卵母细胞数量及胚胎质量均无明显下降,提示畸胎瘤及其手术治疗对卵母细胞质量无明显影响。但冻胚周期临床妊娠率及着床率明显降低,建议这些患者尽可能采用可鲜胚移植的促排方案。

IVF/ICSI treatment process and result in patients with normal ovary reserve function after teratoma operation

Objective:To study the influence of teratoma and its surgical treatment on outcome of assisted reproductive therapy.Methods:The data of 70 patients who had normal ovary reserve function after teratoma operation and underwent the first IVF/ICSI cycle(group A) in our hospital from Jan.2012 to Dec.2015 were analyzed.Meanwhile,78 patients after hydrosalpinx surgery were selected as the controls (group B).The general condition,the first induced ovulation process and pregnancy outcomes were compared between the two groups.Results:There were no significant differences in gonadotropin (Gn) doses,number of oocytes retrieved,normal fertilization rate,cleavage rates and number of available embryo between the patients after teratoma operation and the control group (P ＞ 0.05).In the fresh embryo cycle,there was no significant differencesin clinical pregnancy rate,implantation rate and abortion rate between the two groups (P＞0.05).In the frozen embryo transfer cycle,the clinical pregnancy rate(82.14％) and implantation rate (64.71％)of group B were significantly higher than those of group A(58.14％,37.50％)(P＜0.05).However,there was no significant difference of cumulative clinical pregnancy rate between the two groups (P＞0.05).Conclusions:The number of oocytes retrieved and the embryo quality are not significantly decreased in the patients with normal ovary reserve function after teratoma operation.These results indicate that teratoma and its surgical treatment have no significant effect on oocyte quality.However,the pregnancy rate and implantation rate in FET cycle of this group are significantly lower,which suggests that these patients should receive fresh embryo transfer as far as possible.