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目的分析和探讨体外受精-胚胎移植(IVF-ET)周期最合适的获卵数目。方法对上海集爱遗传与不育诊疗中心2005实施的短方案有获卵的共963个IVF-ET新鲜周期进行回顾性总结和分析,根据不同获卵数分为4组(A组:1~5,B组:6~15,C组:16~25及D组:>25个卵子),就各组的周期数、年龄、平均促性腺激素(Gn)用量及天数、HCG注射日的E2值、全冻胚胎数、放弃周期数、种植率和临床妊娠率进行分析。结果(1)获卵数随年龄增加呈下降趋势。(2)周期完成率在6~15个卵子组最高;A组因缺乏有效胚胎移植,周期放弃率较高;其余3组随获卵数增加,为预防OHSS行胚胎全冻而放弃移植的周期比例也随之明显上升(P<0.01)。(3)Gn用药天数各组差异无显著性,P>0.05。(4)Gn用量随获卵数增加呈下降趋势,呈负相关,差异有显著性(P<0.05);(5)注射HCG日的血清E2值随获卵数增加而明显上升,与获卵数呈正相关,各组之间差异有显著性(P<0.01);(6)种植率(IR)及妊娠率(PR)在B组及D组较A组及C组高,但差异无显著性(P>0·05)。结论适量促性腺激素超促排后的获卵数,在移植有效胚胎数相同的条件下,获卵数多少与其妊娠率差异并无显著意义,但就总体IVF-ET结局而言,短方案IVF-ET周期中获卵数在6~25个之间有较理想的妊娠结局。
Objective To analyze and explore the most suitable number of oocytes retrieved from IVF-ET cycles. Methods A total of 963 fresh cycles of IVF-ET with egg-laying in short program were retrospectively summarized and analyzed according to the number of oocytes retrieved in Shanghai AIDA Treatment and Treatment Center 2005. The patients were divided into 4 groups (group A: 5, group B: 6-15, group C: 16-25 and group D:> 25 eggs). The number of cycles, age, average amount of gonadotrophin (Gn) Value, the number of frozen embryos, to give up the number of cycles, implantation rate and clinical pregnancy rate were analyzed. Results (1) The number of oocytes was declining with increasing age. (2) The cycle complete rate was the highest in 6-15 ovum groups; the cycle abandonment rate was higher in group A due to the lack of effective embryo transfer; the other three groups with the increase of oocyte number, The proportion also increased significantly (P <0.01). (3) There was no significant difference in the days of Gn administration between each group (P> 0.05). (4) The amount of Gn decreased with the number of oocytes retrieved, which was negatively correlated with the difference (P <0.05). (5) The value of serum E2 increased with the number of oocytes injected on HCG day, (P <0.01). (6) Implantation rate (IR) and pregnancy rate (PR) in group B and group D were higher than those in group A and group C, but there was no significant difference Sex (P> 0.05). Conclusions There is no significant difference in the number of oocytes and the pregnancy rate when the number of oocytes retrieved after the right amount of gonadotropin hyperactivity is the same with the same number of effective embryos. However, for the overall IVF-ET outcome, the short-course IVF -ET cycle in the number of oocytes in 6 to 25 have a better pregnancy outcome.