不同甾体激素预处理对高龄女性IVF/ICSI周期结局的影响

Effects of different steroid hormone pretreatment on IVF/ICSI cycle outcome in advanced age women

目的探讨不同甾体激素预处理对高龄IVF/ICSI周期结局的影响。方法回顾性分析了我院2017年1月至2018年3月行IVF/ICSI助孕的患者,根据高龄患者COH前预处理用药的不同分为三组:A组OC处理组,B组雌孕激素处理组,C组为空白组。比较不同甾体激素预处理在高龄患者中对IVF/ICSI周期结局的影响。结果三组的AMH,获卵数,MⅡ卵数,MⅡ卵率,胚胎数,可用胚胎数,高评分囊胚形成比较有统计学意义(P<0.05);其中两两比较发现获卵数,MⅡ卵数,胚胎数,可用胚胎数均是OC处理组与空白组高于雌孕激素预处理组,MⅡ卵率经过OC处理与雌孕激素预处理的患者要显著高于未处理组(P<0.05)。三组的HCG日≥1.8cm卵泡数/≥1.4cm<1.8cm卵泡数无统计学差异,且雌孕激素预处理组有较高的趋势。高评分囊胚形成比雌孕激素预处理组要显著高于OC组及空白组(P<0.05),且OC处理组最低(P<0.05)。结论不同甾体激素预处理对于对高龄IVF/ICSI患者均可提高COH中卵巢的反应性,增加卵泡发育均匀度,增加成熟卵子数。而且高龄中相对卵巢储备功能差的患者雌孕激素预处理还可提高其胚胎的发育潜能。

Objective:To investigate of different steroid hormone pretreatment on IVF/ICSI cycle outcome in advanced age women.Methods:We retrospectively analyzed the patients who underwent IVF/ICSI in our hospital from January 2017 to March2018.The patients were divided into three groups according to the pretreatment:Group A OC treatment group,Group B estrogen and progesterone and the group C are blank group.Compare the effects of different steroid hormone pretreatment on IVF/ICSI cycle outcome in advanced age women.Results:The AMH of the three groups,number of eggs obtained,number of MⅡeggs,rate of MⅡeggs,number of embryos,number of available embryos,and the formation of high-grade blastocysts were statistically significant(P<0.05).Among them,the number of eggs obtained,number of MⅡeggs,tnumber of embryos,number of available embryos were all higher in the OC treatment group and the blank group than that of the estrogen and progesterone pretreatment group.And the rate of MⅡeggs was Significantly higher in treated by OC treatment and estrogen progesterone pretreatment group than the untreated group(P<0.05).There were no statistical differences in the number of follicles between the three groups of HCG≥1.8 cm follicles/≥1.4 cm<1.8 cm,and the estrogen and progesterone pretreatment group had a higher trend.The high-grade blastocyst formation was significantly higher in estrogen and progester group than the OC group and the blank group(P<0.05),and the lowest was in the OC treatment group(P<0.05).Conclusion:Different steroid hormone pretreatment can improve the ovarian response in COH,increase the follicular development uniformity and increase the number of mature eggs in advanced age patients on IVF/ICSI cycle.Moreover,estrogen and progesterone pretreatment on patients of poor ovarian reserve can also improve the developmental potential of their embryos.