卵巢不同反应性在新鲜及冻融胚胎移植周期中的妊娠及并发症结局

Complication and Pregnancy Outcome of Different Ovarian Responses in Fresh and Freezing Embryo Transfer Cycles

目的对比体外受精-胚胎移植周期中卵巢不同反应性的妊娠及其并发症结局。方法回顾性分析郑州大学第一附属医院生殖中心2005年6月—2006年12月1098个获卵周期,包括716个IVF周期和382个ICSI周期。分为:卵巢高反应组(A组,n=114个);卵巢中反应组(B组,n=770个);卵巢低反应组(C组,n=214个)。对比3组的年龄、Gn量、受精率、卵裂率、优质胚胎率、移植胚胎数目、种植率、临床妊娠率、取消移植周期率、流产率、OHSS率、冷冻周期率及累计妊娠率等。结果①卵巢反应从高到低,平均年龄和平均Gn量随呈升高趋势,但是3组比较均无统计学差异(P>0.05);C组的优质胚胎率及妊娠率均显著低于A组与B组(P<0.05);②3组的流产率、A与C组的取消ET周期率均高于B组,但是3组比较均无显著差异(P>0.05);A组的中、重度OHSS率显著高于B及C组(P<0.05);③A组与B组的平均冷冻胚胎数、冷冻周期率、冻融妊娠率及累计妊娠率均明显高于C组(P<0.05)。结论新鲜加冻融周期中卵巢中反应是最佳的超排卵方案;不仅累计妊娠率高而且并发症低,患者承担经济支出最低。

Objective To contrast the complication and pregnancy outcome of different ovarian responses in fresh and freezing embryo transfer cycles.Methods A retrospective review of 1098 retrieval oocyte cycles from June 2005 to December 2006 in our center,including high ovarian response group（A group,n=114）,Moderate ovarian response group（B group,n=770）,Poor ovarian response group（C group,n=214）.The outcome of age,Gn quantity,the fertilized rate,cleaved rate,good embryo rate,embryos transferred rate,embryos implanted rate,clinical pregnancy rate,cancel transfer cycle rate,abortion rate,the ovarian hyperstimulation syndrome（OHSS）,freezing cycles,accumulative pregnancy rate were compared between the three groups.Results ①Three are increasing trend in mean age and Gn quantity from high to poor ovarian response,but no statistically significant difference was found between the three groups（P〈0.05）.The good embryo rate declined significantly in C group than other two groups（P〈0.05）.②No statistically significant difference in abortion rate and cancel transfer cycle rate was found between the three groups（P〈0.05）.The OHSS rate increased significantly in A group than B and C groups（P〈0.05）.③The mean freezing embryo number,freezing cycles,freezing pregnancy rate and accumulative pregnancy rate increased significantly in A and B group than C groups（P〈0.05）.Conclusion The moderate ovarian response is the best project in fresh embryo transfer and freezing cycles.The patients not only get the high accumulative pregnancy and low the complication,but also take on the lowest economy payout.