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目的:探讨月经期取卵在卵巢低储备(diminished ovarian reserve,DOR)患者体外受精-胚胎移植(IVF-ET)中应用的可行性。方法:回顾性分析70例DOR行IVF/卵胞质单精子注射(ICSI)-ET治疗的不孕症患者的临床资料,比较其73个月经期取卵和270个非月经期取卵的结局。若月经2~4 d阴道超声提示优势卵泡直径≥14 mm且E2水平>200 ng/L则行月经期取卵,若无优势卵泡按常规促排卵方案行IVF/ICSI,观察其临床结局。结果:月经期组获卵数、成熟卵数和可用胚胎数分别为1.0±0.4个、0.8±0.4个、0(0,1)个,非月经期组分为1.6±1.2个、1.4±1.1个、1(0,1)个,组间有统计学差异(P<0.05)。月经期组周期取消率为72.6%,显著高于非月经期组43.0%(P<0.05)。月经期组获卵率、卵裂率、卵子利用率分别为83.1%、94.7%和34.5%,非月经期组分别为70.6%、96.7%和51.7%,组间无统计学差异(P>0.05)。结论:尽管月经期取卵的获卵数、成熟卵数、可用胚胎数小于非月经期取卵,但获卵率、卵裂率和卵子利用率组间无统计学差异,为反复周期取消、高基础雌激素的DOR不孕症患者节约了治疗时间,提供了新的方法。
Objective: To investigate the feasibility of oocyte retrieval during menstrual cycle in vitro fertilization-embryo transfer (IVF-ET) in patients with diminished ovarian reserve (DOR). Methods: The clinical data of 70 infertile patients treated with IVF / cytoplasmic sperm injection (ICSI) -ET were retrospectively analyzed. The results of ovulation in 73 menstrual periods and 270 non-menstrual cycles were compared. Menstrual ovulation was performed if the dominant follicle diameter ≥ 14 mm and E2 level> 200 ng / L at 2 to 4 days of menstrual vaginal ultrasound. IVF / ICSI was performed according to routine ovulation induction without dominant follicles. The clinical outcome was observed. Results: The numbers of oocytes, mature eggs and available embryos in the menstrual period were 1.0 ± 0.4, 0.8 ± 0.4 and 0 (0, 1), respectively. The non-menstrual period was 1.6 ± 1.2 and 1.4 ± 1.1 1 (0,1), there was a statistically significant difference between groups (P <0.05). The menstrual cycle cancellation rate was 72.6%, significantly higher than the non-menstrual period 43.0% (P <0.05). The oocyte retrieval rate, cleavage rate and egg utilization rate in the menstrual period were 83.1%, 94.7% and 34.5% respectively, and those in the non-menstrual period were 70.6%, 96.7% and 51.7% respectively, with no significant difference (P> 0.05 ). Conclusion: Although the number of oocytes retrieved in the menstrual period, the number of mature oocytes and the available embryos are smaller than those of the non-menstrual period, there is no significant difference between the oocyte retrieval rate, cleavage rate and egg utilization rate, High Basal Estrogen DOR infertility patients save time and provide a new approach.