| 引用本文: | 彭丽君,谢奇君,杨烨,陈雨婷,胡晴云,凌秀凤.拮抗剂方案中PCOS患者HCG日直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值对FET结局的影响[J].中国临床新医学,0,():-. |
| Peng Lijun.拮抗剂方案中PCOS患者HCG日直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值对FET结局的影响[J].中国临床新医学,0,():-. |
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| 摘要: |
| 【摘要】目的：探讨抗剂方案HCG日直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值对接受拮抗剂方案的多囊卵巢综合征（polycystic ovarian syndrome, PCOS）患者中体外受精（in vitro fertilization, IVF）周期胚胎发育情况及冻融胚胎移植（frozen-thawed embryo transfer, FET）助孕结局的影响。方法： 回顾性分析2016年1月至2021年12月我院进行拮抗剂方案助孕，行全胚冷冻且进行首次FET的PCOS患者的临床资料。根据三分位法将HCG注射日直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值分为多组：A组：直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值＜0.43（n=262）；B组：0.43≤直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值＜0.56（n=267）；C组：直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值≥0.56（n=247），比较各组间的促排情况、实验室指标及FET妊娠结局。结果：基础LH, LH /FSH B组显著高于A、C组(P<0.05)。Gn使用总量A组显著高于B、C组(P<0.05)； HCG日E2 B、C组显著高于A组(P<0.05)。获卵数，2PN数，卵裂数，囊胚形成数以及可移植胚胎数B、C组显著高于A组(P<0.05)；囊胚形成率C组显著高于A、B组 (P<0.05)。各组间高评分囊胚率、移植胚胎数、胚胎种植率、生化妊娠率、临床妊娠率、流产率、活产率等无显著性差异（P>0.05）。结论：PCOS患者在IVF治疗中，HCG日直径16-18mm 卵泡数/大于等于 14mm 卵泡数的比值可反应卵母细胞发育潜能，该比值≥0.56时可获得较好的获卵数，2PN数，卵裂数，囊胚形成数以及可移植胚胎数，此比值可能是PCOS患者HCG扳机时机潜在参考指标。 |
| 关键词: 多囊卵巢综合征 体外受精-胚胎移植 卵泡直径 扳机时机 拮抗剂方案 |
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| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
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| Impact of the ratio of number of follicles 16-18 mm in diameter/number of follicles greater than or equal to 14 mm on HCG day on FET outcomes in PCOS patients on antagonist regimens |
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Peng Lijun1,2,3
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1.Women'2.'3.s Hospital of Nanjing Medical University
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| Abstract: |
| Objective: To investigate the influence of ratio of 16-18mm follicles to total follicles on human chorionic gonadotropin (HCG) trigger day on IVF/ICSI outcome in polycystic ovary syndrome (PCOS) women who received GnRH-ant protocol for controlled ovarian hyperstimulation (COH).Methods: Women with PCOS (n=776) who underwent the GnRH-ant protocol for COH and underwent FET between January 2016 and December 2021 were stratified as group A (Ratio < 0.43, n=262) , group B (0.43 ≤ Ratio < 0.56, n=267) and Group C (Ratio ≥ 0.56, n=247) according to the ratio of 16-18mm follicles to total follicles on the HCG trigger day. The baseline characteristics, outcomes of COH and the first frozen embryo transfer (FET) cycle were compared between group A, B and C.Results: Group B had higher levels of Baseline LH and LH/FSH compared with Groups A and C (P < 0.05). Group A had the highest total Gn dose (P < 0.05) and the lowest E2 levels on the HCG trigger day (P < 0.05) compared with Groups B and C. The number of retrieved oocytes, normally fertilized oocytes (2PN), fertilized oocytes, blastocyst, and transferable embryos were significantly higher in Groups B and C compared to Group A (P < 0.05). The blastocyst formation rate in Group C was significantly higher than that in Groups A and B (P < 0.05). There were no significant differences among three groups in high-quality blastocyst rate, number of embryos transferred, embryo implantation rate, biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, and live birth rate (P > 0.05). Conclusion: 16-18mm follicles to total follicles ratio on HCG trigger day could be an indicator of clinical outcomes in women with PCOS undergoing GnRH-ant protocols and the ratio ≥0.56 may be the better condition for more retrieved oocytes, 2PN oocytes, fertilized oocytes, blastocyst, and transferable embryos. |
| Key words: Polycystic ovarian syndrome In vitro fertilization - embryo transfer Follicle diameter Trigger timing GnRH antagonist protocol |
