hCG剂量与IVF/ICSI高反应患者获卵率的相关性

Dosage effects of human chorionic gonadotropin on oocyte recovery rates among high responder IVF/ICSI patients

目的探讨在IVF/ICSI周期中高反应患者人绒毛膜促性腺激素(human chorionic gonadotropin,h CG)剂量与获卵率的相关性;方法回顾性分析2012年1月至2014年5月于我院生殖中心行第一周期IVF/ICSI的患者345名的数据资料,根据诱发卵泡成熟时h CG的剂量分为3组:4000 IU,5000 IU及10 000 IU组,比较3组间获卵率、卵母细胞成熟率、受精率、妊娠率、流产率及卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)发生率。结果随着h CG剂量的增加,获卵率显著增加(4000,5000与10 000 IU h CG组分别为78.6%vs.81.9%vs.84.1%,P<0.01)。卵母细胞的成熟率及受精率、临床妊娠率、活产率及OHSS发生率3组间无显著性差异。结论在长方案IVF/ICSI周期中,诱导排卵的h CG剂量与高反应患者的获卵率呈正相关,但并不影响妊娠率及活产率。

Objective： Although human chorionic gonadotropin （hCG） has been available for more than 50 years, the lowest effective dose for IVF has not been established. The purpose of the study was to evaluate the effects of different doses of hCG on oocyte recovery rates in high responders. Methods： A total of 345 high responders were recruited and divided into three groups according to the hCG dose administered to trigger final oocyte maturation. Results： We found that the oocyte recovery rate increased significantly as the dose of hCG increased （78.6% to 81.9% to 84.1% with 4000, 5000, and 10, 000 IU hCG, respectively, P〈0.01 ） . The rates of oocyte maturation and fertilization when ICSI was performed were comparable and the clinical pregnancy rates as well as the incidence of OHSS were similar among the groups. Conclusion： The results indicate that a decrease in the dose of hCG adversely affects the oocyte recovery rate without any influence on the probability of pregnancy in high responders.