国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2018, Vol. 37 ›› Issue (4): 281-284.

• 论著 • 上一篇    下一篇

高龄卵巢功能低下女性采取改良的自然周期体外受精-胚胎移植的临床结局

刘珊，包莉莉，冯晓晔，王冬雪，杨波   

  1. 050082  石家庄，中国人民解放军白求恩国际和平医院
  • 收稿日期:2018-03-22 修回日期:2018-05-07 出版日期:2018-07-15 发布日期:2018-07-15
  • 通讯作者: 杨波，E-mail：yangbo_email@sohu.com E-mail:yangbo_email@sohu.com

The Clinical Outcomes of Modified Natural-Cycle for Ageing Women with Poor Ovarian Responder During IVF-ET

LIU Shan，BAO Li-li，FENG Xiao-ye，WANG Dong-xue，YANG Bo   

  1. Bethune International Peace Hospital of The Chinese People′s Liberation Army，Shijiazhuang 050082，China
  • Received:2018-03-22 Revised:2018-05-07 Published:2018-07-15 Online:2018-07-15
  • Contact: YANG Bo，E-mail：yangbo_email@sohu.com E-mail:yangbo_email@sohu.com

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摘要： 目的：高龄卵巢功能低下女性采用微刺激方案行体外受精/胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）未获成功，改用改良的自然周期促排卵方案，观察其临床结局，探讨高龄卵巢功能低下女性的助孕方案。方法：2016年1月—2017年6月在我中心第1周期应用微刺激促排助孕治疗未获成功的高龄卵巢功能低下女性25例，第2周期改为改良的自然周期促排卵助孕方案。采取自身对照，比较2种促排卵方案中性激素水平、卵泡大小、获卵数、胚胎情况和妊娠结局。结果：改良的自然周期方案中卵泡平均直径及扳机日雌二醇（E2）水平与微刺激方案比较差异有统计学意义[（19.8±1.3）mm vs.（17.8±1.0）mm，（582.1±165.9）pmol/L vs.（681.4±99.1）pmol/L，均P＜0.05]，获卵数低于微刺激方案[（1.0±0.0）个 vs.（2.7±1.4）个]，但是卵母细胞成熟率（100%）、正常受精率（100%）及优质胚胎率（80%）高于微刺激方案（分别为80.6%，81.5%，36.4%），差异均有统计学意义（均P＜0.05）。结论：高龄卵巢功能低下女性采用改良的自然周期，虽然获卵数不及微刺激周期，但提高了胚胎质量，妊娠结局与微刺激周期一致。

关键词: 生殖技术, 辅助, 排卵诱导, 卵巢功能低下, 改良的自然周期

Abstract: Objective：To analyze the clinical outcomes of the modified natural-cycle for ageing women with poor responder who failed to get pregnancy in the first in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) of minimal ovarian stimulation, and to discuss the treatment protocols of ageing women with poor ovarian reservation. Methods：This is a retrospective study. A total of 25 ageing women with poor ovarian reservation who failed to get pregnancy the first IVF/ICSI-ET cycle with minimal stimulation protocol were changed to the modified natural-cycle in our center from January 2016 to June 2017. The level of serum E2, the follicle size on the trigger day, the number of oocytes retrieved, the rate of oocyte maturation, the fertilization rate, the high quality embryos rate, and the clinical pregnancy rate, the miscarriage rate and the ectopic pregnancy rate were compared in the self-controlled design. Results：There were significant differences in the average diameter of follicle and the E2 level on the trigger day between the modified natural-cycle group and the minimal stimulation cycle group [(19.8±1.3) mm vs. (17.8±1.0) mm, (582.1±165.9) pmol/L vs. (681.4±99.1) pmol/L, both P＜0.05]. Although the number of oocytes retrieved in the modified natural-cycle group [(1.0±0.0) vs. (2.7±1.4)] was lower than that in the minimal stimulation cycle group, the rate of oocyte maturation (100%), the fertilization rate (100%) and the high quality embryos rate (80%) were significantly higher than that in the minimal stimulation cycle group (80.6%, 81.5% and 36.4%, all P＜0.05). Conclusions：The modified natural-cycle can make the almost same outcomes as the minimal stimulation cycle by the improved significantly quality of the embryo in those ageing women with poor ovarian reservation, although the number of oocytes retrieved was even lower in their modified natural-cycles.

Key words: Reproductive techniques, assisted, Ovulation induction, Poor ovarian responder, Modified natural-cycle