控制超排卵中获卵数与体外受精胚胎移植结局的关系

Impact of the Number of Oocytes Retrieved in Controlled Ovarian Hyperstimulation on the Outcome of In Vitro Fertilization and Embryo Transfer

目的：探讨控制超排卵（COH）中获卵数对体外受精-胚胎移植（IVF—ET）结局的影响，及超排卵中最佳获卵数。方法：接受IVF—ET或卵细胞浆内单精子显微注射（ICSI）助孕治疗的不孕症患者221例，其中获卵数〈5者31例（Ⅰ组），获卵数5—10者96例（Ⅱ组），获卵数11—15者49例（Ⅲ组），获卵数〉15者45例（Ⅳ组），回顾性分析4组IVF／ICSI结局。结果：Ⅰ组临床妊娠率（25．8％）明显低于第Ⅱ、Ⅲ、Ⅳ组，差异有极显著统计学意义（P〈0．01），Ⅳ组临床妊娠率（40％）低于Ⅱ组（53．13％）及Ⅲ组（53．04％），但差异无统计学意义（P〉0．05），而重度卵巢过度刺激综合征（OHSS）Ⅳ组发生4例（8．89％），Ⅲ组1例（2．04％），Ⅰ、Ⅱ组无发生。结论：在COH中获卵数5—15个时临床妊娠率最高，获卵数≤10个时可避免重度OHSS发生。

Objective： To evaluate the impact of the number of retrieved oocytes in controlled ovarian hyperstimulation（CHO） on the outcome of in vitro fertilization embryo transfer（IVF-ET） and the optimal number of the retrieved oocytes. Methods： 221 infertile couples that accepted at least one IVF or intracytoplasmie sperm injection （ICSI） treatment cycles in our hospital during Jan 2004 to Jul 2005 were evaluated retrospectively. They were divided into four groups according to the number of oocytes retrieved： group Ⅰ：31 cases （ the number of retrieved oocytes 〈5） ,group Ⅱ：96 cases （ the number of retrieved oocytes was 5 ～ 10） ,group Ⅲ：49 eases （the number of retrieved ooeytes was 11 ～ 15）, group Ⅳ ：45 eases （ the number of retrieved oocytes 〉 15）. Results： Clinical pregnancy rate in group Ⅰ（25.8% ） was significantly lower than other groups（P 〈0.01 ）. There were no statistically differences in clinical pregnancy rates arcing the other three groups, but the risk of severe ovarian hyperstimulation syndrome（OHSS） increased significantly in group Ⅳ. Conclusion： The clinical pregnancy rate is highest when the number of retrieved oocytes is 5 ～ 15 in CHO. When the number of retrieved oocytes ≤ 10, the risk of severe OHSS can be avoided.