拮抗剂方案中的排卵延迟对体外受精-胚胎移植妊娠结局的影响

目的 分析体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)新鲜周期,拮抗剂方案对胚胎移植妊娠结局的影响.方法 回顾性分析北京妇产医院生殖医学中心2015年进行体外受精、新鲜胚胎移植的149周期,分析拮抗剂方案中的排卵延迟对IVF-ET的妊娠结局的影响.按照是否用拮抗剂分为2组,其中拮抗剂方案组共83个周期,非拮抗剂方案组共66个周期.结果 非拮抗剂方案组分娩孕周及单胎新生儿体重显著低于拮抗剂方案组(P值分别为0.022、0.010),而2组中双胎低体重儿体重、双胎高体重儿体重、双胎新生儿平均体重差异均无统计学意义(P值分别为0.927、0.754、0.839).非拮抗剂方案组孕早期B超胎囊数、胎心数、临床妊娠率、活产率、剖宫产率、早产率、胎停育率均显著高于拮抗剂组(P值分别为0.000、0.002、0.000、0.019、0.039、0.009、0.024).结论 IVF-ET中拮抗剂方案引起的排卵延迟并未增加早产、胎停育、新生儿低体重等不良妊娠结局的发生率.

Effects of delayed ovulation in GnRH antagonist regimens on pregnancy outcome of in vitro fertilization-embryo transfer

Objective To analyze the effects of GnRH antagonist regimens on pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET)fresh cycle.Methods One hundred and forty-nine female patients were retrospectively analyzed,who underwent IVF and fresh embryo transfer in Reproductive Center of Beijing Obstetrics and Gynecology Hospital in 2015.The patients were divided into two groups according to their ovarian stimulation protocols:83 patients in GnRH antagonist regimens group and 66 patients in non-GnRH antagonist regimens group.Effects of delayed ovulation in antagonist regimens on pregnancy outcome were evaluated.Results The weeks of gestation and the weight of the singletons in non-antagonist group were significantly lower than those of the antagonist group (P =0.022,0.010).While,there were no significant differences of the twins with lower birth weight,the weight of the twins with higher birth weight,and the average weight of the twins between the two groups (P =0.927,0.754,0.839).The number of pregnant sac and fetal heart screened by early gestation ultrasound,clinical pregnancy rate,live birth rate,cesarean delivery rate,preterm birth rate and embryonic diapauses rate were markedly increased in antagonist group compared with non-antagonist group (P =0.000,0.002,0.000,0.019,0.039,0.009,0.024).Conclusion Delayed ovulation in GnRH antagonist regimens may not adversely affect the pregnancy outcome of IVF-fresh embryo transfer.