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目的:探讨体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)过程中基础卵泡刺激素(FSH)水平及获卵数对IVF-ET结局的影响。方法:对180例不孕患者共180个IVF-ET周期的资料进行回顾性分析,比较不同FSH水平和不同获卵数患者年龄、受精率、卵裂率、优质胚胎率和临床妊娠率等指标的差异。结果:不同FSH水平患者年龄、促性腺激素(Gn)剂量、Gn促排时间、移植胚胎数、卵裂率、妊娠率经统计学检验,差异均无统计学意义(P>0.05)。FSH>8.78 IU/L者获卵数明显低于FSH<3.85 IU/L和FSH 3.85~8.78 IU/L组(P<0.05),而受精率和优质胚胎率却明显高于其它2组(P<0.05)。随年龄增长、FSH水平增加获卵数逐渐减少,差异有统计学意义(P<0.05);不同获卵数者的受精率、卵裂率、优质胚胎率、临床妊娠率及中重度卵巢过度刺激综合征(OHSS)发生率,差异均有统计学意义(P<0.05),获卵数≤5个受精率最高,获卵数>15个受精率最低;获卵数6~15个卵裂率、优质胚胎率最高;随着获卵数的增加,临床妊娠率和中重度OHSS发生率也逐渐增高。获卵数和FSH水平呈显著性负相关(r=-0.246,P<0.01);经多因素Logistic回归分析,年龄、获卵数、移植胚胎数与IVF-ET妊娠结局具有相关性(P<0.05)。结论:基础FSH水平不能预测IVF-ET的临床结局,而获卵数可以预测IVF-ET临床结局。
Objective: To investigate the effect of basal follicle stimulating hormone (FSH) level and number of oocytes retrieved on the outcome of IVF-ET during in vitro fertilization and embryo transfer (IVF-ET). Methods: A total of 180 IVF-ET cycles of 180 infertile patients were retrospectively analyzed. The age, fertilization rate, cleavage rate, high-quality embryo rate and clinical pregnancy rate were compared among different FSH levels and different number of oocytes retrieved The difference. Results: There was no significant difference in age, gonadotropin (Gn) dose, Gn promoting time, number of embryos transferred, cleavage rate and pregnancy rate among different FSH levels (P> 0.05). The number of oocytes retrieved by FSH> 8.78 IU / L was significantly lower than that of FSH <3.85 IU / L and FSH 3.85 ~ 8.78 IU / L (P <0.05), while the fertilization rate and quality embryo rate were significantly higher than those of the other two groups <0.05). With age, FSH level increased the number of oocytes gradually decreased, the difference was statistically significant (P <0.05); different oocyte number fertilization rate, cleavage rate, high quality embryo rate, clinical pregnancy rate and moderate to severe ovarian hyperstimulation (OHSS), the difference was statistically significant (P <0.05), the number of oocytes ≤ 5 fertilization highest, the number of oocytes> 15 fertilization minimum; the number of oocytes 6 to 15 cleavage rate , The highest rate of high-quality embryos; with the increase of the number of oocytes, the clinical pregnancy rate and the incidence of moderate-severe OHSS also gradually increased. There was a significant negative correlation between the number of oocytes retrieved and the level of FSH (r = -0.246, P <0.01). Logistic regression analysis showed that age, number of oocytes retrieved, number of embryos transferred and IVF-ET pregnancy outcome were correlated (P < 0.05). Conclusion: The basal FSH level can not predict the clinical outcome of IVF-ET. The number of oocytes retrieved can predict the clinical outcome of IVF-ET.