摘要
目的探讨超短方案在高龄患者进行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)中的疗效。方法回顾性分析326例年龄>38岁女性的IVF-ET周期的临床资料,根据不同促排卵方案分为超短方案组和微刺激方案组。比较和分析2种促排卵方案的疗效。结果超短方案组的获卵数(5.8±0.3)、正常受精数(3.5±0.2)、优质胚胎数(2.5±1.8)和有效胚胎数(2.6±0.2)均高于微刺激方案组(2.4±0.1,1.5±0.1,1.0±1.0,1.7±0.1)(P<0.001);患者的卵裂率和优质胚胎率组间无统计学差异(P>0.05)。但超短方案组每取卵周期累积妊娠率(40.00%)和累积活产率(8.41%)均高于微刺激方案组(30.00%,7.52%)(P<0.001),新鲜胚胎移植取消率(47.00%)明显低于微刺激方案组(99.56%)(P<0.001)。结论对于高龄IVF患者进行促排卵时使用超短方案,可以获得更多的卵母细胞和有效胚胎,增加每取卵周期的累积妊娠率和活产率,并且通过降低新鲜胚胎移植取消率,减少患者的心理负担,对于高龄IVF患者是一种比较好的选择。
Objective To investigate the effect of ultrashort protocols m advanced age patients undergoing in vitro fertilization-erabryo transfer （IVF-ET） procedures. Methods The IVF-ET cycles of 326 women （〉38 years old） were retrospectively analyzed. The patients were divided into ultrashort group and mild group according to the ovarian stimulation protocols. Then the effect of the two ovarian stimulation protocols was compared and analyzed. Results The numbers ofoocytes retrieved （5.8-60.3）, normally fertilized zygotes （3.5-60.2）, top-quality embryos （2.5 _ 1.8） and embryos suitable for transplantation （2.6-/-0.2） were significantly higher in the ultrashort group than those in the mild group （2.4-60.1, 1.5-60.1, 1.0-6 1.0, 1.7__＋0.1） （P〈0.001）. The cleavage rate and the top-quality .embryo rate showed no significant difference between the two groups （/〉〉0.05）. But the cumulative pregnancy rate （40.00%） and the cumulative live birth rate per retrieval cycle （ 8.41% ） in the ultrashort group were significantly higher than those in the mild group （30,00%, 7.52%） （P〈0.001）.The cancellation rate of fresh embryo transfer in ultrashort group （47.00%） was significantly lower than that in the mild group （99.56%）（P〈0.001）. Conclusion The ultrashort protocol is a better choice for the advanced age patients who underwent IVF-ET procedures, because it can bring more oocytes and embryos suitable for transplantation and increase the cumulative pregnancy rate and live birth rate per retrieval cycle consequently. Also it can reduce the cancellation rate of fresh embryo transfer and the osvchological burden ofoatients at the same time.
作者
童婧
郑中
孙赟
洪燕
高敏芝
赵晓明
Tong Jing;Zheng Zhong;Sun Yun;Hong Yan;Gao Minzhi;Zhao Xiaoming(Center for Reproductive Medicine, Renfi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2017年第11期865-869,共5页
Chinese Journal of Reproduction and Contraception
基金
国家自然科学基金项目(81370687)~~
关键词
体外受精-胚胎移植(IVF-ET)
高龄
超短方案
微刺激方案
累积妊娠率
累积活产率
In vitro fertilization-embryo transfer （IVF-ET）
Advanced age
Ultrashort protocol
Mildprotocol
Cumulative pregnancy rate
Cumulat!ve live birth rate
