论文部分内容阅读
目的:比较不同年龄组长方案体外受精-胚胎移植(IVF-ET)临床、实验室指标及妊娠结局的差异。方法:回顾性分析2009年10月~2011年11月在河南省人民医院生殖医学研究所接受新鲜周期长方案降调节IVF-ET助孕治疗的患者,其中符合入选标准的共1 834周期,根据女方患者的年龄分为4组[A组(≤25岁)、B组(26~30岁)、C组(31~35岁)和D组(≥36岁)],比较不同年龄组间的不孕年限、内膜厚度、基础卵泡刺激素(FSH)、体重指数(BMI)、促性腺激素(Gn)天数、Gn总量、卵子数目、2PN数目、可利用胚胎数目、h CG日E2/成熟卵子数、移植胚胎数、孕囊数、临床妊娠率、胚胎种植率、早期流产率,分析年龄对IVF/ICSI-ET临床及实验室指标的影响。结果:4组间内膜厚度、基础FSH、BMI、Gn天数、绒毛膜促性腺激素使用日(h CG日)E2/成熟卵子数、妊娠率和宫外孕率比较差异无统计学意义(P>0.05),但是各组间不孕年限、Gn总量差异有统计学意义,两两比较任意两组间的不孕年限、Gn总量均有统计学意义(P<0.01);各组之间卵子数目、2PN数目、可利用胚胎数目、移植胚胎数比较差异有统计学意义(P<0.05);而A、B、C与D组的种植率、早期流产率比较差异有统计学意义(P<0.05)。结论:1卵巢储备功能好的高龄患者进行长方案IVF-ET助孕可以得到理想的妊娠率,因此长方案对于部分高龄患者仍然是首选。2随着年龄的增加,促排卵药物使用量增加,获卵数及可利用胚胎数减少,胚胎种植率下降,流产率增加,可见年龄通过多个方面影响IVF-ET的过程及结局。
OBJECTIVE: To compare the clinical, laboratory and pregnancy outcomes of IVF-ET in different age groups. Methods: A retrospective analysis of patients who underwent IVF-ET assisted-treatment with long-term regimen of long-term regimen at the Institute of Reproductive Medicine of Henan Provincial People’s Hospital from October 2009 to November 2011 was retrospectively analyzed. A total of 1 834 cycles met the inclusion criteria. The age of the female patients was divided into four groups [group A (≤25 years), group B (26-30 years), group C (31-35 years) and group D (≥36 years)]. Infertility duration, intima thickness, basal follicle stimulating hormone (FSH), body mass index (BMI), days of gonadotrophin (Gn), total amount of Gn, number of eggs, number of 2PN, number of available embryos, The number of mature eggs, the number of embryos transferred, the number of gestational sacs, the clinical pregnancy rate, the embryo implantation rate, the early miscarriage rate and the analysis of the clinical and laboratory indexes of IVF / ICSI-ET. Results: There was no significant difference in the thickness of the intima between the four groups (P> 0.05), the basal FSH, BMI, Gn days, the number of E2 / mature eggs on the day of chorionic gonadotrophin use (h CG day), pregnancy rate and ectopic pregnancy ), But the duration of infertility between groups, Gn total difference was statistically significant, any pairwise comparison of any two groups of years of infertility, Gn total amount was statistically significant (P <0.01); between groups of eggs The number of 2PN, the number of available embryos and the number of embryos transferred were statistically significant (P <0.05), while there was significant difference in the rate of implantation and early miscarriage between groups A, B, C and D (P < 0.05). CONCLUSION: Long-term IVF-ET assisted pregnancy in elderly patients with good ovarian reserve can achieve the ideal pregnancy rate. Therefore, the long-term regimen is still the first choice in some elderly patients. 2 With increasing age, the use of ovulation drugs increased, the number of oocytes retrieved and the number of available embryos decreased, embryo implantation rate decreased, abortion rate increased, we can see that age affects IVF-ET process and outcome in many ways.