对体外受精临床妊娠影响因素的配对研究

MATCHED STUDY ON THE INFLUENCING FACTORS ON THE CLINICAL PREGNANCY OF IN VITRO FERTILIZATION

[目的]用配对研究的方法分析对体外受精临床妊娠的影响因素。[方法]34例患者的68个(每位患者两个周期,均为前次失败,后次临床妊娠)IVF-ET及ICSI周期。用配对研究分析患者的促超排卵(COH)用药情况(促性腺激素(Gn)起始剂量、Gn天数、Gn总量)、HCG注射日卵泡发育状况(直径≥1.4cm卵泡数、最大卵泡直径)、HCG日子宫内膜厚度、HCG日激素水平(LH、E2、P)、卵子质量(获卵数、MⅡ期卵子数、受精数、正常受精数)、胚胎质量(卵裂数、正常卵裂数、冷冻胚胎数、优质胚胎总数)对临床妊娠的影响。[结果]临床妊娠组MⅡ期卵子数、受精数、正常受精数、卵裂数、正常卵裂数、冷冻胚胎数、优质胚胎总数明显高于未妊娠组(P﹤0.05)。[结论]卵子和胚胎质量影响临床妊娠。如何在临床及实验室工作中提高卵子和胚胎质量有待进一步探讨。

[Objective] To analyze the influencing factors of clinical pregnancy of in vitro fertilization by matched study[Methods] 34 patients were performed with 68 IVF-ET and ICSI cycles, whose first cycle was failed and last cycle had clinical pregnancy. Application of matched study to analyze effect of utilization of medicine to promote superovulation （the initial dose of Gn, the day of Gn and the content of Gn）, the status of follicular development at the day of injecting HCG （the number of ovarian follicle with diameter of 1.4cra and above and the largest follicular diameter）, the thickness and the level of hormone of endometrium at the day of HCG （LH, E2 mid P）, the quality of ovum （the number of acquiring ovum, ovum of M Ⅱ stage, fertilization and normal fertilization） and the embroyo （number of cleavage, normal cleavage, freezing embryo and good quality cleavage） on the clinical pregnancy. [Resuits] The numbers of ovum of M Ⅱ stage, fertilization, normal fertilization, cleavage, normal cleavage, freezing embryo and good quality cleavage in clinical pregnant group were significantly higher than those of non-pregnancy group （P 〈 0.05）. [Conclusion ] Quality of ovum and embryos has impact on the clinical pregnancy. It should be further discussion how to improve the quality of ovum and embryos in clinical and laboratory, work.