空卵泡综合征71例临床分析

Clinical analysis of 71patients with empty follicle syndrome

目的探讨超促排卵周期中空卵泡综合征(EFS)发生的可能因素及复发的可能性。方法回顾性分析本院71例空卵泡综合征患者的病历资料,并对其中42例再次接受促排卵周期者的临床资料同第1次进行了比较,分析空卵泡综合征发生的可能因素。结果 71人平均年龄(36.0±4.8)岁,平均不孕年限7.2±4.8年;窦卵泡数(AFC)(5.2±3.8)个;基础卵泡刺激素(bFSH)(10.0±4.7)U/L;直径≥17mm的卵泡数(3.7±3.0)个。再次促排卵患者的控制性促排卵(COH)天数、COH用药总量、HCG日雌二醇(E2)水平、≥12mm卵泡数、≥14mm卵泡数、≥17mm卵泡数、HCG后至取卵时间,与第1次比较均无统计学差异(P>0.05),但HCG用量和取卵日HCG水平显著高于第1次(P<0.05),且97.6%(41/42)获得了卵母细胞。结论高龄(年龄≥35岁)、不孕年限长、卵巢低反应可能与EFS有关;对于某些促排卵患者,可能常规剂量的HCG不足以启动她们的卵母细胞减数分裂,增加HCG剂量有助于避免第2次发生空卵泡综合征;一次EFS并不意味着再次促排时有复发EFS高风险。

Objective： To explore the possible related factors of the empty follicle syndrome（EFS）happened in controlled ovarian hyperstimulation（COH）and the recurrent possibility of empty follicle syndrome. Methods： The data of 71 patients with empty follicle syndrome in our hospital were retrospectively analyzed for exploring the possible related factors of empty follicle syndrome. Among them, 42 patients were accepted COH again,and the outcomes were compared between the two COH processes to analyze the recurrent possibility of empty follicle syndrome. Results： The average age of 71 patients was（36 - 4.8）years, and the average infertile duration was （7.2＋4.8）years. The number of antral follicles（AFC）was（5. 2＋3. 8）. The levels of basis FSH were （10.0_＋4.7）U/L. The number of follicles with diameter more than 17 mm was（3.7±3.0）. The days of CO H,total amount of drug used, estradiol levels on HCG day, number of follicles with diameter≥12 mm, ≥14 mm or≥ 17 ram, the time from injection of HCG to oocyte retrieval were no statistical differences between the two COH processes（P〈 05）. Dose of HCG used and the plasma levels of HCG on the day of oocyte retrieval were significantly different（P〈0.05）, and the oocytes were retrieved from 97.6% （41/ 42） of patients. Conclusions： Advance age（≥ 35 years）, long infertile duration and low ovarian reaction may be associated with empty follicle syndrome. For some patients with ovarian hyperstimulation, the routine dose of HCG may be not enough to start their oocyte meiosis,which requires the more HCG. Increasing HCG dose can help to avoid the happening of second empty follicle syndrome. The empty follicle syndrome occurring once does not mean high risk of recurrence during the second COH.