辅酶Q10对卵巢低反应患者IVF-ET卵巢反应性和妊娠结局的改善效果

Effect of coenzyme Q10 on improving IVF-ET ovarian responsiveness and pregnancy outcome in patients with POR

目的:评估辅酶Q10对既往卵巢低反应(POR)患者卵巢反应性和妊娠结局的改善效果。方法:选取2021年8月至2022年4月在山东中医药大学第二附属医院生殖医学科进行控制性促排卵(COH)、胚胎植入失败或因无可用胚胎取消移植的POR患者35例。下一COH周期前给予辅酶Q10预处理2个月,以相同方案再次进行控制性促排卵,比较两个周期卵巢反应、胚胎学结果及妊娠率。选择同期同年龄段、预期卵巢反应正常、初次进行IVF的患者35例作为对照组。结果:较前一周期,辅酶Q10组的获卵数、MⅡ卵数、受精卵数、可用胚胎数及MⅡ卵率、受精率、胚胎种植率、临床妊娠率均显著提高,差异有统计学意义(P<0.05)。辅酶Q10组与对照组的获卵数、MⅡ卵数、受精卵数、优胚数等比较,差异有统计学意义(P<0.05);两组的早期流产率、临床妊娠率比较差异无统计学意义(P>0.05)。结论:辅酶Q10可显著改善既往无可移植胚胎或胚胎植入失败史POR患者的卵巢储备和刺激反应性,增加获卵数和优质胚胎数,但仍显著低于同年龄段预期卵巢反应正常患者。此外,辅酶Q10能显著提高POR患者临床妊娠率。

Objective:To evaluate the effect of coenzyme Q10(CoQ10)on improving ovarian response and pregnancy outcome in patients with previous poor ovarian response(POR).Methods:35 POR patients who had undergone controlled ovarian hyperstimulation(COH)with failed embryo implantation and cancelled embryo transfer due to no available embryos in the Reproductive Medical Center,the Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine from August 2021 to April 2022 were selected.CoQ10 pretreatment was given for two months before the next cycle,COH was performed again with the same protocol.Ovarian response,embryological results and pregnancy rates of the two cycles were compared.At the same time,35 patients of the same age,normal expected ovarian response and initial IVF were selected as the control group.Results:Compared with the previous cycle,the number of retrieved eggs,MⅡeggs,fertilized eggs,and available embryos were significantly increased,and the MⅡegg rate,fertilization rate,embryo implantation rate and clinical pregnancy rate also had significant improvement.Compared with the control group,there were significant differences in the number of eggs obtained,MⅡeggs,fertilized eggs and excellent embryos,and there was no statistical difference in the early abortion rate and clinical pregnancy rate.Conclusion:CoQ10 can significantly improve the ovarian reserve and stimulation response of POR patients with a history of previous unavailable embryo or embryo implantation failure,and increase the number of retrieved eggs and high-quality embryos,but they’re still significantly lower than those of patients with normal expected ovarian response at the same age.In addition,CoQ10 can significantly improve the clinical pregnancy rate of POR patients.