辅助生殖技术中卵巢低反应影响因素与妊娠结局研究

Study of influencing factors and pregnancy outcome of poor ovarian response in assisted reproductive technology

目的探讨辅助生殖技术(ART)中卵巢对控制性超排卵(COH)低反应的影响因素以及低反应患者的妊娠结局。方法回顾性分析327名首次接受IVF/ICSI-ET治疗的不孕症患者的资料。根据患者COH卵巢反应分为卵巢低反应组(n=137例,获卵数≤5个)和卵巢反应良好组(n=190例,获卵数>5个),分析年龄、基础卵泡刺激素(bFSH)、窦卵泡数等对COH的影响。结果①单因素分析显示影响卵巢低反应发生的因素有年龄、基础卵泡刺激素水平、基础FSH/LH值和窦卵泡数;Logistic多因素回归分析显示:年龄与卵巢反应性呈负相关,窦卵泡数与卵巢反应性呈正相关,且相关程度窦卵泡数>年龄。②卵巢低反应组与卵巢反应良好组的临床妊娠率分别为27.83%和39.16%,两组间临床妊娠率差异有统计学意义(P<0.05)。结论年龄和窦卵泡数可用于预测卵巢的反应性,其中窦卵泡数为最敏感的指标。卵巢低反应影响妊娠结局。

Objective：To investigate the factors related to poor ovarian response to controlled ovarian hyperstimulation（COH） and pregnancy outcome of poor ovarian response patients in assisted reproductive technology（ART）.Methods：A retrospective analysis of 327 first cycles of in vitro fertilization（IVF）/ intracytoplasmic sperm injection（ICSI）.The patients were classified into two groups including poor response（n=137,the number of oocytes retrieved≤5） and normal response（n=190,the number of oocytes retrieved5） according to ovarian response to COH.Age,basal FSH level and antral follicle count（AFC） were analyzed.Results：①Single-variate analysis showed that the poor ovarian response to COH was associated with the age,basal FSH levels,basal FSH/LH and antral follicle count.Multi-variate Logistic regression analysis showed that the ovairan response correlated negatively with the age,and positively with the antral follicle count.② The clinical pregnancy rate of the poor response group（27.83%） was lower than the normal response group（39.16%）（P0.05）.Conclusion：The age and antral follicle count can be used as markers to predict ovarian response during COH and the antral follicle count is the most sensitive one.The pregnancy outcome can be influenced by poor ovarian response.