双刺激方案在低卵泡输出率患者中的应用价值

The application of double ovarian stimulation in the patients with low follicular output rate

目的探讨双刺激方案在低卵泡输出率(FORT)患者中的临床应用价值。方法回顾性分析我院行IVF/ICSI-ET助孕226例低FORT患者资料,67例卵泡期促排卵后继续行黄体期促排卵(双刺激组);159例选择新鲜周期胚胎移植或全胚胎冷冻(低FORT组),对其中60例新鲜及冷冻周期移植未妊娠或妊娠失败的患者行再次常规方案促排卵(对照组),比较各组的临床结局。结果双刺激组中黄体期促排卵的获卵数、MⅡ卵数、2PN受精数、优质胚胎数均显著高于同一周期卵泡期促排卵(P<0.05)。双刺激组的总获卵数、MⅡ卵数、2PN受精数、优质胚胎数、冷冻胚胎数及临床妊娠率均显著高于低FORT组(P<0.05),流产率显著低于低FORT组(P<0.05),但与对照组间差异无显著性。结论双刺激方案能在短时间内累积更多的可利用胚胎,在FET周期获得较满意的临床结局,是低FORT患者有效的补充治疗方式。

Objective To investigate the application value of double ovarian stimulations in the patientswith low follicular output rate（FORT）. Methods The data of 226 cases with low FORT at our hospital were ana-lyzed in this retrospective study. 67 patients received a subsequent luteal phase ovarian stimulation following regu-lar follicular phase stimulation（double stimulations group）. The other 159 patients were performed fresh embryostransfer or whole embryos freezing（low FORT group）,in which 60 patients who were not pregnant or had a pregnan-cy failure after fresh or freezing embryo transfer were served as control group and received conventional ovarianstimulation protocol in the next cycle. The clinical outcomes were compared among groups. Results The numbersof oocytes retrieved,metaphase Ⅱ oocytes,2 PN fertilized oocytes,top-quality embryos in luteal phase stimulationwere significantly higher than those in follicular phase stimulation（P 0.05）. Meanwhile,the parameters of IVFmentioned above along with cryopreserved embryos and the clinical pregnancy rate in double stimulations were sig-nificantly higher and the rate of abortion was significantly lower than low FORT group（P 0.05）,which were simi-lar to control group（P 0.05）. Conclusions With the advantages of obtaining more available embryos in lesstime,the double stimulation could be served as an effective supplementary intervention for the patients with lowFORT.