摘要
目的:分析亚临床甲状腺功能减退(亚甲减)患者行体外受精胚胎移植治疗时的胚胎情况。方法:选取2014年6月至2017年10月于安徽省皖南医学院弋矶山医院生殖医学中心接受第一次体外受精-胚胎移植(IVF-ET)助孕的患者249人为研究对象,其中亚甲减67例,甲状腺功能正常患者182例,所有亚甲减患者在进周期时给予左旋甲状腺素片(优甲乐)治疗。利用回顾性分析方法,比较两组患者的获卵数、体外成熟(MⅡ)卵数、受精率、卵裂率、补救卵泡浆内单精子注射(ICSI)率、优胚率等。结果:两组患者受精率、卵裂率和补救ICSI率差异有统计学意义(P<0.05),而获卵数、MⅡ卵数及优胚率差异无统计学意义(P>0.05)。结论:亚甲减患者进周期时虽给予治疗,维持TSH水平2.5 m IU/mL,但仍有可能会降低受精率、卵裂率及增加补救ICSI率,故认为给予患者药物治疗亚甲减,维持甲状腺功能的稳定是必要的。
AIM: To investigate the effects of in vitro fertilization( IVF) on embryo acquisition in patients with subclinical hypothyroidism. METHODS: A total of 249 human subjects who received in vitro fertilization and embryo transfer( IVF-ET)for the first time in the reproductive medicine center of Wannan Medical College affiliated Yijishan Hospital from June 2014 to October 2017 were included and divided into two groups,with 67 cases of subclinical hypothyroidism,and 182 cases of normal thyroid function. Patients with subclinical hypothyroidism received levothyroxine sodium tablets at the beginning of treatment. Retrospective analysis was used to compare the number of retrieved oocytes,MII eggs,fertilization rate,cleavage rate,rescue ICSI rate,and high quality embryo rate between two groups. RESULTS: There were significant differences in fertilization rate,cleavage rate and salvage ICSI rate between the two groups( P < 0. 05),but there was no significant difference in the number of retrieved oocytes,the number of MII eggs and the rate of high quality embryos( P > 0. 05). CONCLUSION: Though patients with subclinical hypothyroidism received treatment to maintain TSH≤2. 5 m IU/m L,they may still present lower fertilization rate,cleavage rate and higher rescue ICSI rate,hence drug maintenance is essential for subclinical hypothyroidism to maintain thyroid function.
引文
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