改良自然周期在体外受精-胚胎移植中对年轻卵巢低反应患者的临床应用价值

Clinical application value of modified natural cycle for young patients with poor ovarian response during in vitro fertilization-embryo transfer

目的:探讨改良自然周期行体外受精-胚胎移植(IVF-ET)在年轻卵巢低反应患者中的临床应用效果。方法:回顾性分析2011年8月至2012年10月因卵巢低反应在唐山市妇儿医院生殖遗传科行改良自然周期IVF-ET的65例患者共86个周期的临床资料,按患者年龄分为<35岁组与≥35岁组分组统计。结果:65例患者共86个周期中,9个周期因卵泡提前破裂而取消周期,取卵周期取消率为10.47%,77个取卵周期,获卵45枚,获卵率为58.44%,正常受精率为80.00%,获胚胎率71.11%,优质胚胎率为28.13%,移植25个周期,移植周期临床妊娠率为36%。两组患者的获卵率随着年龄的增加而下降(63.88%,53.65%),差异有统计学意义(P<0.05);两组的优胚率随着年龄的增加而下降(40.00%,17.65%),差异有统计学意义(P<0.05);两组的妊娠率随着年龄的增加而下降(46.15%,25.00%),差异有统计学意义(P<0.05)。结论:改良自然周期方案可明显降低卵巢低反应患者行IVF-ET的取卵周期取消率,特别是对年轻患者可获得相对满意的临床妊娠率。

Objective, To explore the clinical application value of modified natural cycle for young patients with poor ovarian re- sponse during in vitro fertilization - embryo transfer （IVF -ET） . Methods. The clinical data of 65 patients （86 cycles） receiving modi- fied natural - cycle IVF - ET because of poor ovarian response in the hospital from August 2011 to October 2012 were analyzed retrospective- ly; the patients were divided into 〈 35 -year- old group and 335 -year- old group according to age. Results： A total of 86 cycles （65 patients） were studied, 9 cycles were canceled because of advanced rupture of follicles, the cancel rate was 10. 47%, 45 oocytes were re- trieved during 77 cycles, the oocyte retrieval rate was 58.44%, the normal fertilization rate was 80. 00%, the embryo retrieval rate was 71.11%, the high quality embryo rate was 28. 13%, the clinical pregnancy rate was 36% during 25 transplantation cycles; the oocyte re- trieval rates in the two groups were 63, 88% and 53.65%, respectively, which decreased with age, there was statistically significant differ- ence （P （0.05） ~ the high quality embryo rates in the two groups were 40. 00% and 17. 65%, respectively, Which decreased with age, there was statistically significant difference （P 〈0, 05） ; the pregnancy rates in the two groups were 46. 15% and 25.00%, respectively, which decreased with age, there was statistically significant difference （P 〈 0. 05 ） . Conclusion： Modified natural - cycle program can sig- nificantly reduce cycle cancel rate of patients with poor ovarian response during IVF - ET, especially for the young patients, relatively satis- factory clinical pregnancy rate can by obtained.