多囊卵巢综合征不孕患者行新鲜与冷冻周期胚胎移植妊娠结局的比较
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摘要
目的:探讨多囊卵巢综合征患者行新鲜与冻融胚胎移植对妊娠结局和新生儿体重的影响。方法:选取行体外受精-胚胎移植(IVF-ET)助孕的100例多囊卵巢综合征患者为研究对象,依移植的胚胎类型分为新鲜胚胎组(n=49)和冷冻胚胎组(n=51),新鲜胚胎组以新鲜胚胎种植,冷冻胚胎组全部胚胎冷冻后行冻融胚胎移植。观察并对比两组患者促排卵情况、妊娠结局和新生儿体重。结果:两组患者促性腺激素(Gn)起始剂量、促排卵时间比较差异无统计学意义。冷冻胚胎组的Gn总用量比新鲜胚胎组低,且其注射人绒毛膜促性腺激素(hCG)日雌激素(E_2)、孕激素(P)水平、卵泡数和获卵数均较新鲜胚胎组高,胚胎种植率、临床妊娠率较新鲜胚胎组高,差异有统计学意义(P<0.05);冷冻胚胎组卵巢过度刺激综合征(OHSS)发生率较新鲜胚胎组低,差异有统计学意义(P<0.05);两组患者自然流产率、早产率、多胎率及新生儿出生体重、低体重出生儿比例差异无统计学意义。结论:对于多囊卵巢综合征患者的IVF-ET助孕治疗,行冷冻周期胚胎移植与新鲜周期胚胎移植的新生儿体重相似,但前者能获得更良好的妊娠结局。
Objective: To explore the effect of fresh embryo transfer or frozen embryo transfer on the pregnang outcome of women with polycystic ovary syndrome(PCOS) and the influence on neonates' weight. Methods: 100 PCOS patients treated with in vitro fertilizatim and embryo transfer(IVF-ET) were divided into fresh group(49 cases) and frozen group(51 cases) by the type of transplanted embryo. Fresh group was treated by fresh embryo transfer,frozen group was treated by frozen embryo transfer. The situation of ovulation induction、pregnancy outcome and neonates' weight were comparatively analyzed. Results: There was no statistical difference between the fresh group and frozen group in the starting dose of gonadotropin(Gn)、 ovulation induction time. The total dose of Gn in the frozen group was lower than that in the fresh group, Estradiol(E_2) from the day of human chorionic gonadotropin(hCG) injection、 the level of progestin(P)、 antral follicle count、 obtained antral follicle count in the frozen group were higher than those in the fresh group, Implantation rate、clinical pregnancy rate in the frozen group were higher than those in the fresh group(P<0.05), the incidence of ovarian hyperstimulation syndrome(OHSS) in the frozen group was lower than that in the fresh group(P<0.05). There was no statistical difference between the fresh group and frozen group in the spontaneous abortion rate、premature birth rate、multiple birth rate、neonates' weight and low-birth-weight rate(P>0.05). Conclusion: In the IVF-ET treatment of patients with polycystic ovary syndrome,both fresh embryo transfer and frozen embryo transfer can obtain similar neonates' weight, but the latter can obtain better pregnancy outcome.
Objective: To explore the effect of fresh embryo transfer or frozen embryo transfer on the pregnang outcome of women with polycystic ovary syndrome(PCOS) and the influence on neonates' weight. Methods: 100 PCOS patients treated with in vitro fertilizatim and embryo transfer(IVF-ET) were divided into fresh group(49 cases) and frozen group(51 cases) by the type of transplanted embryo. Fresh group was treated by fresh embryo transfer,frozen group was treated by frozen embryo transfer. The situation of ovulation induction、pregnancy outcome and neonates' weight were comparatively analyzed. Results: There was no statistical difference between the fresh group and frozen group in the starting dose of gonadotropin(Gn)、 ovulation induction time. The total dose of Gn in the frozen group was lower than that in the fresh group, Estradiol(E_2) from the day of human chorionic gonadotropin(hCG) injection、 the level of progestin(P)、 antral follicle count、 obtained antral follicle count in the frozen group were higher than those in the fresh group, Implantation rate、clinical pregnancy rate in the frozen group were higher than those in the fresh group(P<0.05), the incidence of ovarian hyperstimulation syndrome(OHSS) in the frozen group was lower than that in the fresh group(P<0.05). There was no statistical difference between the fresh group and frozen group in the spontaneous abortion rate、premature birth rate、multiple birth rate、neonates' weight and low-birth-weight rate(P>0.05). Conclusion: In the IVF-ET treatment of patients with polycystic ovary syndrome,both fresh embryo transfer and frozen embryo transfer can obtain similar neonates' weight, but the latter can obtain better pregnancy outcome.
引文
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[5] 周晶,李博,陈书强,等.冻融胚胎与新鲜胚胎移植的新生儿结局比较[J].生殖医学杂志,2017,26(1):9-13.
[6] 葛明晓,陶莉莉,邓伟民.卵巢过度刺激综合征的中西医诊疗研究进展[J].现代中西医结合杂志,2014,23(14):1587-1591.
[7] 徐蓓,靳镭.在高反应人群中如何预防卵巢过度刺激综合征[J].生殖医学杂志,2017,26(11):1071-1074.
[2] 林佳,朱如如,赵军招,等.多囊卵巢综合征患者促排卵中不同干预措施预防卵巢过度刺激的效果[J].温州医科大学学报,2015,45(7):519-524.
[3] 杨慧云.达英-35治疗PCOS高雄激素血症疗效观察[J].中外健康文摘,2009,6(30):127.
[4] 吴亚兰,张慧莉.PCOS患者血清性激素水平与胰岛素抵抗的相关性分析[J].浙江临床医学,2016,18(9):1712-1713.
[5] 周晶,李博,陈书强,等.冻融胚胎与新鲜胚胎移植的新生儿结局比较[J].生殖医学杂志,2017,26(1):9-13.
[6] 葛明晓,陶莉莉,邓伟民.卵巢过度刺激综合征的中西医诊疗研究进展[J].现代中西医结合杂志,2014,23(14):1587-1591.
[7] 徐蓓,靳镭.在高反应人群中如何预防卵巢过度刺激综合征[J].生殖医学杂志,2017,26(11):1071-1074.