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目的探讨在辅助生育技术过程中出现卵巢过度刺激综合征(OHSS)倾向患者进行全胚冷冻,以预防OHSS发生,后进行冷冻胚胎移植的应用价值。方法选择2009年1月至2010年12月在本中心进行ART患者,共取卵1722周期,其中具有OHSS倾向患者201周期,占总取卵周期的11.67%,分极高危OHSS倾向组和高危OHSS倾向组两组。极高危OHSS倾向组给予全部胚胎冷冻,以后再安排冷冻胚胎移植,对于高危OHSS倾向组给予新鲜胚胎移植。比较促排卵药的使用总量及使用天数、HCG日E2水平、平均获卵数、平均胚胎数、平均优质胚胎数、OHSS发生率情况。比较全部胚胎冷冻进行复苏后移植与新鲜胚胎移植比较平均移植胚胎数、平均移植优质胚胎数、妊娠率、着床率、早期流产率等。结果1.两组患者的平均年龄、不孕年限、促排卵药的使用总量和天数无显著性差异;但全胚冷冻组HCG日E2水平、平均获卵数、平均胚胎数、平均优质胚胎数及OHSS发生率均高于新鲜周期移植组。2.全胚冷冻后行冷冻胚胎移植组与新鲜周期移植组的平均移植胚胎数、平均移植优质胚胎数、妊娠率、着床率、早期流产率均无显著性差异。结论 1.全胚冷冻不能减少早发型OHSS发生;2.为预防OHSS行全胎冷冻后,再行冷冻胚移植不影响不孕症患者治疗结局。
Objective To investigate the value of frozen embryo transfer in patients with ovarian hyperstimulation syndrome (OHSS) predisposed to cryogenic embryo implantation in the process of assisted reproductive technology to prevent the occurrence of OHSS. Methods From January 2009 to December 2010, ART patients were enrolled in our center for 1722 cycles, with 201 cycles of OHSS predation, accounting for 11.67% of the total oocyte retrieval cycle, ultra-high-risk OHSS predisposition group and high-risk OHSS Tendency group two groups. Very high-risk OHSS tended to give all embryos frozen, and later frozen embryos were arranged to give fresh embryos for high-risk OHSS-prone groups. To compare the total amount of ovulation-promoting drugs used and the number of days, the E2 level on HCG day, the average number of oocytes retrieved, the average number of embryos, the average number of high-quality embryos and the incidence of OHSS. Compare the average number of embryos transplanted with fresh embryo transplantation, the average number of transplanted embryos, pregnancy rate, implantation rate, early abortion rate and so on. The average age of two groups of patients, the duration of infertility, the total amount of ovulation induction use and the number of days did not have significant difference; but the whole embryo frozen group HC level of E2, the average number of oocytes, the average number of embryos, the average high quality embryos The number of OHSS and the incidence of OHSS were higher than those of the fresh-cycle group. There was no significant difference in average number of embryos transferred, average number of embryos transferred, pregnancy rate, implantation rate and early miscarriage rate between frozen embryo transfer group and fresh one. Whole-body cryopreservation can not reduce the occurrence of early-onset OHSS; 2. To prevent OHSS line whole-body freezing, re-cold embryo transfer does not affect the therapeutic outcome of infertility patients.