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目的分析HCG注射日直径≥16mm的卵泡占≥14mm卵泡群的比例对IVF/ICSI结局的影响,探讨HCG扳机的最佳时机。方法回顾分析2014年1月1日至2015年12月31日在本中心接受短效长方案促排卵的IVF/ICSI治疗周期,符合纳入标准的共2 391周期。根据HCG日卵泡群直径分布的不同,以直径≥16mm的卵泡占直径≥14mm卵泡群的比例分为三组:高比例组(>75%)、中比例组(50%~75%)、低比例组(≤50%),比较三组患者临床和实验室指标。结果三组患者的年龄、体重指数(BMI)、基础FSH比较,差异均无统计学意义(P>0.05);基础窦卵泡数(AFC,双侧)在高比例组[(14.65±4.07)]显著低于低比例组[(16.10±4.38)]及中比例组[(15.26±4.22)](P<0.05);高比例组获卵数[(9.43±4.36)]显著低于低比例组[(12.62±5.28)]和中比例组[(11.00±4.28)](P<0.05),且全胚冷冻率(39.73%)也显著低于低、中比例组(分别为57.88%和43.38%)(P<0.05);三组的受精率、优质胚胎率、临床妊娠率、多胎妊娠率、异位妊娠率和中重度OHSS的发生率均无显著差异(P>0.05);流产率在低比例组(1.61%)显著低于中、高比例组(分别为10.48%和15.17%)(P<0.05)。结论 HCG日直径≥16mm的卵泡占≥14mm卵泡群不同的比例分布并不显著影响IVF/ICSI的实验室指标和临床妊娠率。
Objective To analyze the influence of the proportion of follicles with diameter ≥16mm on the IVF / ICSI on the day of HCG injection and the optimal timing of HCG triggers. Methods A retrospective analysis was conducted from January 1, 2014 to December 31, 2015 on IVF / ICSI treatment cycles for short-term and long-term ovulation induction in our center, which met the inclusion criteria for a total of 2 391 cycles. According to the distribution of follicles in HCG, the proportion of follicles with diameter ≥16mm in follicles with diameter≥14mm were divided into three groups: high proportion group (> 75%), medium proportion group (50% -75%), low Scale group (≤50%), comparing the clinical and laboratory indexes of three groups of patients. Results There was no significant difference in age, body mass index (BMI) and basal FSH between the three groups (P> 0.05). The number of basal antral follicles (AFC, bilateral) in the high proportion group [(14.65 ± 4.07)] (P <0.05). The number of oocytes in the high proportion group [(9.43 ± 4.36)] was significantly lower than that in the low proportion group [(16.10 ± 4.38)] and the middle ratio group [(15.26 ± 4.22) (12.62 ± 5.28) and medium (11.00 ± 4.28), respectively (P <0.05), and the rate of whole embryo freezing (39.73%) was also significantly lower than that of the low and middle ratio groups (57.88% and 43.38% (P0.05) .The fertilization rate, high-quality embryo rate, clinical pregnancy rate, multiple pregnancy rate, ectopic pregnancy rate and the incidence of moderate-severe OHSS had no significant difference among the three groups (P0.05) Group (1.61%) was significantly lower than the medium and high proportion group (10.48% and 15.17% respectively) (P <0.05). Conclusion The different proportions of follicles with ≥ 14mm follicles with ≥ 16mm diameter on HCG day did not significantly affect the IVF / ICSI laboratory and clinical pregnancy rates.