巧囊或其他原因所致的卵巢储备功能下降患者IVF/ICSI助孕结局的比较

Comparison on IVF/ICSI promoting gestation outcomes of patients with ovarian reserve function decline that result from artful bursa or from other reasons

目的比较巧囊（子宫内膜异位囊肿）所致的卵巢储备功能下降与其他原因所致的卵巢储备功能下降患者的体外受精（IVF）/卵胞浆内单精子注射（ICSI）助孕结局。方法选取2014年10月-2015年7月于本中心198例IVF/ICSI助孕年龄〈40岁的卵巢储备功能下降的患者（共计311个周期）,按是否合并巧囊（术后或未手术）分为两组。A组：合并巧囊的卵巢储备功能下降患者;B组：非合并巧囊的卵巢储备功能下降患者。采用回顾性病例对照分析,分别比较两组患者的基本情况、控制性超促排卵相关数据、实验室相关数据及妊娠结局。结果两组患者在辅助生殖技术（ART）方案、超促排卵方案、Gn起始量、Gn总量、获卵数、2PN数、优势胚胎数、移植胚胎数、移植率、妊娠率、流产率、异位妊娠率、单胎妊娠率及多胎妊娠率比较,差异均无统计学意义（P〉0.05）。巧囊所致卵巢储备功能下降患者的平均年龄显著低于非巧囊组[（33.67±0.34）岁vs（35.04±0.19）岁,P〈0.01];基础促卵泡生成激素（FSH）显著低于非巧囊组[（9.85±0.46）m IU/ml vs（11.79±0.34）m IU/ml,P〈0.01],但是巧囊所致的卵巢储备功能下降的患者,其好胚率显著低于非巧囊组（13.76%vs 25.42%,P〈0.01）。结论巧囊所致的卵巢储备功能下降与非巧囊所致的卵巢储备功能下降相比,其优质胚胎率显著下降,可见巧囊在导致卵巢储备功能下降的同时还会使得卵子质量下降。

Objective To compare IVF/ICSI promoting gestation outcomes of patients with ovarian reserve function decline that result from artful bursa(ovarian endometrial cyst) or from other reasons. Methods 198 ovarian reserve function decline patients from October 2014 to July 2015 in our center whose IVF/ICSI promoting gestation age were less than 40 years were selected from our center(a total of 311 cycles).Patients were divided into two groups according to whether combined with artful bursa(postoperative or not operation) or not: group A,ovarian reserve function decline patients combined with artful bursa;group B,varian reserve function decline patients did not combine with artful bursa.The basical situation,control over stimulate ovulation related data,laboratory related data and gestation outcomes of two groups were compared by using retrospective case-control analysis. Results There were no statistical significance between two groups in ART project,over stimulate ovulation project,Gn initial amount,Gn total amount,get ovum number,2PN number,advantages embryo number,number of transferred embryos,transplantation rate,pregnancy rate,abortion rate,ectopic pregnancy rate,single pregnancy rate and multiple pregnancy rate(P>0.05).Although the average age of ovarian reserve function decline patients that result from artful bursa was obvious lower than non artful bursa group [(33.67 ±0.34) years vs(35.04±0.19) years,P<0.01] and basical FSH was obvious lower than non artful bursa group [(9.85 ±0.46)m IU/ml vs(11.79±0.34) m IU/ml,P<0.01],the good embryo rate was obvious lower than non artful bursa group(13.76%vs 25.42%,P<0.01). Conclusion Comparing the ovarian reserve function decline between result from artful bursa and non artful bursa,the good embryo rate has decreased obviously.So,we can preliminarily conclud that artful bursa also make the egg quality decline at the same at leading to decrease ovarian reserve function.