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目的:探讨体外受精-胚胎移植/卵母细胞质内单精于注射(IVF/ICSl-ET)中卵巢低反应发生的相关因素及结局分析。方法:回顾分析2008年1月～2009年8月采用激动剂短方案控制性超排卵(COH)的患者,同时满足①经阴道超声下取卵,获卵数<3个,②HCG日E2<500 Pg/ml为卵巢低反应标准,取同期采用激动剂短方案COH患者获卵4～20个为正常反应组,即对照组(203例),分析两组的年龄、窦卵泡数、基础FSH(bFSH)、基础LH(bLH)、基础E2(bE2)、周期取消率、Gn用量、平均用药天数、受精率及临床妊娠率等。结果:两组患者比较,低反应组年龄、bFSH、周期取消率、卵巢手术史比率明显高于对照组(P<0.001),Gn用量两组相比有非常显著性差异(P<0.001),窦卵泡数、临床妊娠率明显低于对照组(P<0.001),受精率两组相比有显著性差异(P<0.05),而不孕年限、bE2、bLH、平均用药天数两组相比无明显差异(P>0.05)。结论:患者年龄、bFSH、窦卵泡数、有卵巢手术史可预测卵巢低反应的发生,卵巢低反应患者Gn刚量大,临床妊娠预后差。
Objective: To investigate the related factors and outcome analysis of ovarian low response in in vitro fertilization-embryo transfer / intracytoplasmic sperm injection (IVF / ICSl-ET). Methods: A retrospective analysis of patients with controlled-superovulation (COH) using short-term agonist from January 2008 to August 2009 was conducted. At the same time ① ovulation by transvaginal ultrasonography was performed. The number of oocytes was <3 and E2 <500 on HCG day Pg / ml is the standard of low ovarian response, take the short period of agonist short-course COH patients oocytes 4 to 20 as the normal reaction group, the control group (203 cases), analysis of two groups of age, antral follicles, basal FSH bFSH, basal LH, bE2, cycle cancellation rate, Gn dosage, average medication days, fertilization rate and clinical pregnancy rate. Results: Compared with the control group, the rates of bFSH, cycle cancellation rate and ovarian surgery in the low response group were significantly higher than those in the control group (P <0.001). There was a significant difference in the amount of Gn between the two groups (P <0.001) The number of antral follicles and clinical pregnancy rate were significantly lower than those in the control group (P <0.001). The fertilization rate was significantly different between the two groups (P <0.05), while the number of days of infertility, bE2, bLH, No significant difference (P> 0.05). Conclusions: The age of patients, bFSH, the number of antral follicles and the history of ovarian surgery can predict the occurrence of ovarian low response. The patients with low response to ovariectomy have a large amount of Gn and the prognosis of clinical pregnancy is poor.