卵巢低反应患者黄体期促排卵优质胚胎形成影响因素分析

Factors affecting formation of high-quality embryo in poor ovarian responders with luteal phase stimulation

目的评估卵巢低反应(POR)患者中黄体期促排卵优质胚胎形成影响因素。方法回顾性分析2013年6月至2018年12月于河北医科大学第四医院使用黄体期促排卵(LPS)行IVF/ICSI助孕的POR患者的临床资料,根据受精后72 h是否有优质胚胎分为2组:优胚组(优质胚胎≥1枚),无优胚组(优质胚胎=0)。对影响优质胚胎形成的因素进行单因素及多因素Logistic回归分析。结果共纳入患者133例,平均年龄(37.80±5.83)岁、不孕年限(4.98±3.60)年、获卵数(3.13±2.60)个、优质胚胎数(1.67±0.87)个。单因素Logistic回归分析示,扳机日≥14 mm卵泡数(OR=1.343)、获卵数(OR=1.479)、MⅡ卵数(OR=1.757)、2PN受精数(OR=3.226)、可利用胚胎数(OR=3.553)与优质胚胎形成呈正相关(P均<0.05);基础FSH水平(OR=0.928)、扳机日LH水平(OR=0.855)与优质胚胎形成呈负相关(P均<0.05)。多因素Logistic回归分析显示,2PN受精数(aOR=2.504)与优质胚胎形成显著相关(P=0.038)。结论卵巢低反应患者采用LPS方案促排卵,基础FSH、扳机日≥14 mm卵泡数、扳机日LH水平、获卵数、MⅡ卵数、2PN受精数、可利用胚胎数与优质胚胎形成相关,2PN受精数是优质胚胎形成的显著相关因素。

Objective:To evaluate factors affecting formation of high-quality embryos in poor ovarian responders(POR)with luteal phase ovulation stimulation(LPS).Methods:The clinical data of the POR patients undergone IVF/ICSI treatment with LPS in the Fourth Hospital of Hebei Medical University from June 2013 to December 2018 were retrospectively analyzed.The patients were divided into two groups according to whether existence of high-quality embryos 72 hours after fertilization:high-quality embryos(≥1)group and non-high-quality embryos group.Factors affecting high-quality embryos were analyzed by using univariate and multivariate logistic regression.Results:One hundred and thirty-three patients were included,with an average age(37.80±5.83)years,infertility duration(4.98±3.60)years,number of oocytes retrieved(3.13±2.60),high-quality embryos(1.67±0.87).Univariate analysis showed that numbers of≥14 mm follicles on the trigger day(OR=1.343),oocytes retrieved(OR=1.479),number of MⅡoocytes(OR=1.757),2PN embryos(OR=3.226)and available embryos(OR=3.553)were positively associated with formation of high-quality embryos(all P<0.05),whereas basic levels of FSH(OR=0.928)&LH(OR=0.855)on the trigger day were negatively associated with formation of high-quality embryos(all P<0.05).Multivariate analysis showed that only the number of 2PN embryos(aOR=2.504)was positively associated with formation of high-quality embryos(P=0.038).Conclusions:Basic FSH level,number of≥14 mm follicles on the trigger day,LH level on the trigger day,number of oocytes retrieved,number of MⅡoocytes,number of 2PN embryos,number of available embryos are associated with formation of high-quality embryos,while number of 2PN embryos is a significant related factor for high quality embryo formation.