高压氧疗法用于卵巢低反应不孕症患者IVF/ICSI-ET辅助治疗对妊娠结局的影响

The effect of hyperbaric oxygen therapy on pregnancy outcomes in infertile patients with poor ovarian response treated with IVF/ICSI-ET

目的探讨高压氧疗法(HBOT)用于卵巢低反应(POR)不孕症患者IVF/ICSI-ET辅助治疗对妊娠结局的影响。方法回顾性分析2019年2月至2023年6月在海军军医大学附属长海医院生殖医学中心因POR行IVF/ICSI-ET治疗的不孕症患者的临床资料(共86个周期),根据是否应用HBOT辅助治疗,分为研究组(HBOT联合促排卵治疗,n=43)和对照组(仅行促排卵治疗,n=43)。比较两组患者的基本情况、干预前后卵巢功能相关指标、促排卵情况及妊娠结局,并对研究组和对照组前一治疗周期与本周期的促排卵及胚胎发育情况进行比较。结果两组患者的年龄、体质量指数(BMI)、不孕因素等基本资料均无显著性差异(P>0.05)。研究组和对照组内干预前后FSH、E_(2)水平及FSH/LH、基础窦卵泡计数(AFC)比较均无显著性差异(P>0.05),但研究组HBOT联合促排卵治疗后的FSH水平显著低于对照组促排后水平[(9.51±1.69)U/L vs.(11.75±4.44)U/L,P<0.001]。研究组中,前一周期和本周期的获卵数、MⅡ卵数、卵裂数及受精数比较均无显著性差异(P>0.05),但本周期获胚数[(1.91±0.94)枚vs.(1.30±0.67)枚]和优质胚胎数[(1.83±1.01)枚vs.(0.98±0.66)枚]显著高于前一周期(P<0.05);对照组前一周期与本周期的各参数比较均无显著性差异(P>0.05)。两组间比较,研究组本周期的获胚数[(1.91±0.94)枚vs.(1.51±0.80)枚]及优质胚胎数[(1.83±1.01)枚vs.(1.28±0.66)枚]显著高于对照组本周期(P<0.05)。研究组的临床妊娠率与对照组比较有升高趋势(32.6%vs.22.4%),但尚无显著性差异(P>0.05)。研究组行HBOT后均无不良反应发生。结论HBOT用于POR患者的IVF/ICSI-ET辅助治疗,可能有利于增加患者的获胚数和优质胚胎数,临床妊娠率也有提升趋势,且无明显不良反应发生。

Objective:To explore the influence of hyperbaric oxygen therapy(HBOT)on pregnancy outcomes in infertile patients with poor ovarian response(POR)treated with IVF/ICSI-ET.Methods:A retrospective analysis of clinical data(86 cycles)of infertile patients who underwent IVF/ICSI-ET treatment for POR at the Reproductive Medicine Center of Changhai Hospital Affiliated to Naval Medical University from February 2019 to June 2023 was conducted.Based on the use of HBOT as an adjuvant therapy,they were divided into a study group(HBOT combined with ovulation induction therapy,n=43)and a control group(only ovulation induction therapy,n=43).The basic characteristics,ovarian function related indicators before and after intervention,ovulation induction status,and pregnancy outcomes of the two groups were compared,and the ovulation induction and embryo development of the previous treatment cycle and the current cycle were compared between the study group and the control group.Results:There were no significant differences in basic characteristics such as age,body mass index(BMI),and infertility factors between the two groups(P>0.05).There were no significant differences in FSH level,E_(2)level,FSH/LH,and basal antral follicle count(AFC)between the study group and the control group before and after intervention(P>0.05).However,the FSH level in the study group after HBOT combined with ovulation induction treatment were significantly lower than those in the control group after ovulation induction[(9.51±1.69)U/L vs.(11.75±4.44)U/L,P<0.001].In the study group,there were no significant differences in the number of retrieved oocytes,MⅡoocytes,cleavage,and fertilization between the previous and current cycles(P>0.05),but the number of embryos obtained in the current cycle and the number of high-quality embryos were significantly higher than those of the previous cycle[(1.91±0.94)vs.(1.30±0.67)and(1.83±1.01)vs.(0.98±0.66),P<0.05].There were no significant differences in various parameters between the previous cycle and the current cycle in the control group(P>0.05).The number of embryos obtained in the study group[(1.91±0.94)vs.(1.51±0.80)]and the number of high-quality embryos[(1.83±1.01)vs.(1.28±0.66)]were significantly higher than those in the control group in the current cycle(P<0.05).The clinical pregnancy rate of the study group showed an increasing trend compared to the control group(32.6%vs.22.4%),showing no significant difference(P>0.05).There were no adverse reactions in the study group after HBOT treatment.Conclusions:The use of HBOT as an adjuvant therapy for IVF/ICSI-ET in POR patients may be beneficial in increasing the number of embryos obtained and high-quality embryos,and the clinical pregnancy rate also shows an upward trend without significant adverse reactions.