Department of Obstetrics and Gynaecology, Centre of Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Hum Reprod. 2011 May;26(5):1091-6. doi: 10.1093/humrep/der048. Epub 2011 Feb 28.
The evidence underpinning the timing of an oocyte collection in IVF or ICSI is limited. The aim of this study was to assess the effect of the follicle diameter size of the dominant follicle on ongoing pregnancy rates.
We conducted a randomized controlled trial, including women aged between 18 and 43 years who were scheduled for GnRH agonist down-regulated IVF/ICSI treatment in four assisted conception units. Women were randomized between timing oocyte collection when the leading follicle had a diameter of 22 mm or when the leading follicle had a diameter of 18 mm. The primary end-point was ongoing pregnancy, defined as a viable pregnancy at 12 weeks of gestation.
The trial had major problems with recruiting patients and after the planned 2 years of recruiting only half of the aimed 400 inclusions were obtained. We allocated 97 women to the 22-mm group and 93 women to the 18-mm group. In the 22-mm group more women reached an ongoing pregnancy (37 of 97 women, 38%) compared with the 18-mm group (22 of 93 women, 24%) resulting in a relative risk of 1.6 [95% confidence interval (CI): 1.03-2.5]. In a logistic regression analysis, the timing of oocyte collection, adjusted for female age, IVF/ICSI and centre, was still associated with ongoing pregnancy, although the association was no longer statistically significant (OR: 2.0; 95% CI: 0.96-4.2) CONCLUSIONS: This study suggests that delaying the timing of oocyte collection in IVF or ICSI results in better ongoing pregnancy rates, however, larger studies have to be performed to prove or refute these findings.
ISRCTN24724622.
在 IVF 或 ICSI 中取卵时机的证据有限。本研究旨在评估优势卵泡直径大小对持续妊娠率的影响。
我们进行了一项随机对照试验，纳入了年龄在 18 至 43 岁之间、计划在四个辅助受孕单位接受 GnRH 激动剂下调 IVF/ICSI 治疗的女性。将这些女性随机分为两组，一组在主导卵泡直径为 22mm 时取卵，另一组在主导卵泡直径为 18mm 时取卵。主要终点是持续妊娠，定义为妊娠 12 周时的活产妊娠。
该试验在招募患者方面遇到了重大问题，在计划的 2 年招募时间内，仅完成了目标 400 例纳入的一半。我们将 97 名女性分配到 22mm 组，93 名女性分配到 18mm 组。在 22mm 组中，更多的女性达到了持续妊娠（97 名女性中有 37 名，38%），而在 18mm 组中，这一比例为 93 名女性中有 22 名（24%），相对风险为 1.6（95%置信区间：1.03-2.5）。在一项 logistic 回归分析中，调整了女性年龄、IVF/ICSI 和中心等因素后，取卵时机仍与持续妊娠相关，尽管这种关联不再具有统计学意义（比值比：2.0；95%置信区间：0.96-4.2）。
这项研究表明，在 IVF 或 ICSI 中延迟取卵时机可提高持续妊娠率，但需要进行更大规模的研究来证实或反驳这些发现。
ISRCTN24724622。
