赠卵体外受精供受双方临床疗效及影响因素分析

Analysis on clinical efficacy and effect factors of IVF-ET results of oocyte donation in recipient and donor groups

目的:探讨赠卵体外受精-胚胎移植(IVF-ET)供受双方的治疗结局和影响因素。方法:回顾分析2005年4月至2009年12月在河北医科大学第二医院生殖中心行IVF-ET并自愿捐卵的17例供卵患者及同期接受赠卵的16例受卵患者,共19周期的临床资料。供卵组(17例)采用控制性超排卵行IVF-ET;受卵组(16例)采用自然周期或激素替代治疗准备子宫内膜,并分析供、受双方的受精率、妊娠率和种植率。结果:16例患者19周期共接受赠卵108枚,平均每周期接受卵子(5.68±0.82)枚,21个解冻移植周期,8周期妊娠,周期妊娠率为38.1%,累计妊娠率50.0%。供卵的17例患者,10个新鲜胚胎移植周期,2周期妊娠;19个解冻胚胎移植周期,12周期妊娠,冷冻移植周期的妊娠率为63.16%,累计妊娠率64.71%。供、受双方受精率、冷冻胚胎移植周期的妊娠率、累积妊娠率均无统计学差异(P>0.05)。结论:受卵IVF-ET是治疗卵巢功能不良等不能生育健康后代妇女的有效方法;自然周期、激素替代周期可使种植率和临床妊娠率可以达到良好的结局;供卵者提供6个左右的卵子既不影响供卵者的妊娠,也能为受卵者提供一个良好的妊娠机会。

Objective：To explore the clinical efficacy and effect factors of IVF-ET results of oocyte donation in recipient and donor groups.Methods：The clinical data of 17 oocyte donors receiving IVF-ET voluntarily and 16 oocyte recipients at the same period in the hospital from April 2005 to December 2009 were analyzed retrospectively, 19 cycles were included in the study; 17 oocyte donors （donors group） received controlled ovarian hyperstimulation IVF-ET; 16 oocyte recipients （recipients group） received natural cycle and hormone replacement therapy to prepare endometrium, the fertilization rates, pregnancy rates and implantation rates of the two groups were analyzed.Results：16 recipients （19 cycles） received 108 oocytes, （5.68±0.82） oocytes per cycle, the recipients at 8 cycles got pregnancy among 21 thawed transplantation cycles, the pregnancy rate per cycle was 38.1%, the cumulative pregnancy rate was 50.0%.In donors group, the donors at 2 cycles got pregnancy among 10 fresh IVF-ET cycles; the donors at 12 cycles got pregnancy among 19 thawed transplantation cycles, the pregnancy rate per cycle was 63.16%, the cumulative pregnancy rate was 64.71%.There was no significant difference in fertilization rate, pregnancy rate of thawed oocytes transplantation cycles and cumulative pregnancy rate between the two groups （P〉0.05）.Conclusion：Oocytes donation is an effective method for women with ovarian dysfunction or genetic diseases; natural cycle and hormone replacement cycle may achieve high implantation rate and clinical pregnancy rate; 6 oocytes produced by oocyte donors do not affect pregnancy of oocyte donors, which may provide a good chance for oocyte recipients to pregnancy.