年轻隐匿型原发性卵巢功能不全患者的试管受精妊娠结局研究

IVF Pregnancy Outcome of Young Occult POI Patients Better than Aged Patients

目的比较病理性卵巢储备功能下降(DOR)即年轻隐匿型原发性卵巢功能不全(POI)患者与生理性DOR(高龄)患者的试管受精(IVF)助孕治疗的妊娠结局,以期为临床工作提供指导。方法回顾性分析2015年1月—2016年12月在广东省妇幼保健院生殖中心行IVF-ET治疗的符合纳入标准的257例患者的275例IVF-ET治疗周期(其中POI组77个周期,高龄组198个周期)的临床、实验室及随访资料(包括妊娠结局等)。结果与高龄组相比,POI组的年龄较小,抗苗勒氏激素(AMH)较低,不孕时间较短,取卵数、成熟卵子数、优质胚胎数较少,但胚胎种植率、生化妊娠率及临床妊娠率较高,自然流产率较低,差异均有统计学意义(P<0.05)。结论尽管年轻隐匿型POI妇女卵巢储备功能已显著降低,卵巢产生的卵子数量已减少,但其质量并未下降,仍可获得较好的IVF妊娠结局。

Objective To compare the IVF pregnancy outcomes of the pathological DOR patients( young occult POI patients) and the physiologic DOR patients( aged patients). Methods The clinical,laboratory and follow-up( including pregnancy outcomes) data of 275 cycles in 257 patients in accordance with the inclusion criteria( including 77 cycles of occult POI patients and 198 cycles of aged patients) undergoing IVF-ET in Reproductive Medicine Center of Guangdong Women and Children Hospital between January 2015 to December 2016 were retrospectively reviewed. Results Compere to the aged patients,the age,AFCs,AMH,infertility time,number of retrieved oocytes,number of mature oocytes and number of high quality embryos were lower in young occult POI patient. However,the embryo implantation rate,the biochemical pregnancy rate and the clinical pregnancy rate are preferable,the spontaneous abortion rate is lower in young occult POI patient,differences were statistically significant( P < 0. 05). Conclusion Although the ovarian reserve function and the number of oocytes of young occult POI patients has been already significantly reduced,the quality of oocytes has not been reduced,the young occult POI patients can still obtain good pregnancy outcomes.