Reproductive Medicine, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
Acta Obstet Gynecol Scand. 2011 Jul;90(7):761-6. doi: 10.1111/j.1600-0412.2011.01139.x. Epub 2011 May 20.
The aim of this study was to compare pregnancy and live birth rates in poor responders when transferring one or two embryos. Poor responders were defined as having four or fewer oocytes retrieved in combination with a high dose of gonadotrophins.
Retrospective, observational study.
Reproductive Medicine, University Hospital. Methods and Sample. All fresh cycles, in total 5 351, performed during the years 2003-2008 were included, where 367 cycles were poor responders.
Pregnancy and live birth rates.
In the poor responders, the live birth rate per oocyte pick-up and per embryo transfer was 10.9 and 16.3%, respectively, compared with 23.9 and 27.7%, respectively, in the normal responders (p=0.0001 and p=0.01, respectively). In the poor responders, the live birth rate per single embryo transfer was 10.8%, compared with 27.8% per double embryo transfer (DET; p=0.0014) and in normal responders 28.1 vs. 26.6%, respectively (p=0.34). Multiple birth rates after DET were 9.1% in the poor responders and 25.6% in the normal responders.
This study confirms that poor responders have overall lower live birth rates after in vitro fertilization treatment compared with normal responders. The live birth rate after DET in poor responders was clinically and statistically significantly higher than after single embryo transfer, with a modest increase in multiple birth rates. Thus, in poor responders, DET might be considered more often than in normal responders. Single embryo transfer should, however, be the first option among women stimulated with a low/normal dose of gonadotrophins irrespective of the number of retrieved oocytes.
本研究旨在比较在使用高剂量促性腺激素时，仅移植一枚或两枚胚胎的情况下，卵巢反应不良患者的妊娠率和活产率。卵巢反应不良定义为获卵数为 4 个或更少。
回顾性观察性研究。
生殖医学，大学医院。方法和样本：本研究纳入了 2003 年至 2008 年期间进行的所有新鲜周期（共 5351 个周期），其中 367 个周期为卵巢反应不良。
妊娠率和活产率。
在卵巢反应不良患者中，每取卵周期和每胚胎移植周期的活产率分别为 10.9%和 16.3%，而正常反应患者分别为 23.9%和 27.7%（p=0.0001 和 p=0.01）。在卵巢反应不良患者中，单胚胎移植的活产率为 10.8%，而双胚胎移植（DET）的活产率为 27.8%（p=0.0014）；在正常反应患者中，单胚胎移植的活产率为 28.1%，而 DET 的活产率为 26.6%（p=0.34）。DET 后多胎妊娠率在卵巢反应不良患者中为 9.1%，在正常反应患者中为 25.6%。
本研究证实，与正常反应患者相比，卵巢反应不良患者的体外受精治疗后整体活产率较低。在卵巢反应不良患者中，DET 的活产率显著高于单胚胎移植，且多胎妊娠率略有增加。因此，在卵巢反应不良患者中，DET 的应用可能比在正常反应患者中更为常见。然而，对于接受低剂量/正常剂量促性腺激素刺激的女性，无论获卵数多少，单胚胎移植都应作为首选。
