卵巢对控制性超排卵反应的回顾性研究

A retrospective study on responses of left and right ovaries to controlled ovarian hyperstimulation

目的探讨在体外受精-胚胎移植中卵巢对控制性超排卵的反应性。方法回顾性分析57例实施体外受精-胚胎移植的治疗周期，病例组43例，均为因输卵管因素不孕者；对照组14例，因男性因素不孕或多囊卵巢综合征者。比较两组血清基础卵泡刺激素、黄体生成激素、雌二醇、人绒毛膜促性腺激素、日雌二醇水平、促性腺激素总量、促性腺激素天数及每组患者左右侧卵巢窦卵泡数、停促性腺激素日卵泡直径、获卵数、成熟卵子数。结果两组血清基础黄体生成激素、雌二醇、人绒毛膜促性腺激素日雌二醇水平无明显差异，病例组基础卵泡刺激素水平、促性腺激素总量及促性腺激素天数均高于对照组（t值分别为1.21、1．65、2．62，均P〈0．05）；两组患者左右侧卵巢停促性腺激素日8-14mm、15-19mm卵泡数无明显差异，但右侧卵巢窦卵泡数、停促性腺激素日20mm以上卵泡数、获卵数、成熟卵子数均高于左侧（病例组：t值分别为1．70、2．81、2．64、1．23，对照组：t值分别为1．25、2．17、1．82、2．98，均P〈0．05）。结论在体外受精-胚胎移植的控制性超排卵治疗周期中。右侧卵巢的反应性明显优于左侧。

Objective To investigate responses of left and right ovaries to controlled ovarian hyperstimulation （COH） in IVF-ET. Methods 57 infertility patients underwent IVF-ET were assigned into study group （ n = 43, infertility due to tubal factors） and control group （ n = 14, infertility due to polycystic ovarian syndrome.or husband＇s factors ）. All the patients received COH with Gn for varied treatment circles. The serum levels of FSH, LH, E2 at baseline and level of E2 on hCG administration day, total administration amount and days of Gn, numbers of antral follicles in left and right ovaries, follicle diameter, number of oocytes and number of mature oocytes on the Gn withdrawing day of the infertility patients in the two groups were compared. Results In LH, E2 at baseline, E2 on the hCG administration day, there were no significant differences between the two groups. While in serum level of FSH at baseline, the total administration amount and administration days of Gn in the study group were higher than those in the control group （t = 1.21,1.65,2.62,respectively, all P 〈 0.05 ）. In number of follicles with diameter of 8-14mm and 15-19mm in left and right ovaries on the day of withdrawing Gn, there were no significant differences between the two groups, while the number of antral follicles, number of follices with diameter over 20mm, number of oocytes, number of mature oocytes in the right ovary were significantly higher than those in the left ovary （ in the study group ： t = 1.70, 2.81,2.64 and 1.23, respectively , all P 〈 0.05 ; in the control group ： t = 1.25,2.17,1.82 and 2.98, all P 〈 0. 05 ）. Conclusion In treatment circles in IVF-ET, response of the right ovary to COH is superior to one of the left ovary.