Roesner Sabine, Pflaumer Ulrike, Germeyer Ariane, Montag Markus, Strowitzki Thomas, Toth Bettina
Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University of Heidelberg, Voßstr. 9, 69115, Heidelberg, Germany,
Arch Gynecol Obstet. 2014 Jun;289(6):1347-54. doi: 10.1007/s00404-013-3123-2. Epub 2013 Dec 20.
Natural cycle (NC) IVF/ICSI has proven to be an alternative to conventional IVF/ICSI cycles.
Within our retrospective, observational study (n = 159) infertile couples underwent (n = 463) cycles of NC-IVF/ICSI from May 2007 until December 2011. Oocyte pick-up was performed within a pure natural cycle excluding any hormonal stimulation except of hCG for ovulation induction. Oocytes were fertilized by IVF/ICSI and embryo transfer took place 2 or 3 days later. In addition, the current literature was analysed concerning pregnancy rates in NC-IVF/ICSI cycles.
Oocyte pick-up was performed in n = 463 NC and was successful in n = 342 cases (IVF n = 135, ICSI n = 207). 203 oocytes were fertilized (IVF n = 87, ICSI n = 116, FR 59.4 %) and lead to 192 embryo transfers. Finally, 25 pregnancies were reached (PR 13.0 % per transfer) resulting in four biochemical pregnancies, 7 (33.3 %) miscarriages, one pregnancy of unknown outcome and 13 live births. Within the current literature (n = 27 studies), PR in NC-IVF/ICSI cycles varied between 10.2 and 50 %.
Within our study, pregnancy rates in pure NC-IVF/ICSI remained below 15 %. Although this may be linked to unfavourable preconditions like patients' age >40 years, low ovarian reserve or long duration of infertility, further improvement is necessary to increase pregnancy rates.
自然周期（NC）体外受精/卵胞浆内单精子注射（ICSI）已被证明是传统体外受精/ICSI周期的一种替代方案。
在我们的回顾性观察研究（n = 159）中，2007年5月至2011年12月期间，不孕夫妇接受了（n = 463）个NC-IVF/ICSI周期治疗。取卵在纯自然周期内进行，除用于诱导排卵的人绒毛膜促性腺激素（hCG）外，不使用任何激素刺激。卵母细胞通过体外受精/ICSI受精，并在2或3天后进行胚胎移植。此外，对当前关于NC-IVF/ICSI周期妊娠率的文献进行了分析。
在463个NC周期中进行了取卵，342例成功（体外受精n = 135，ICSI n = 207）。203个卵母细胞受精（体外受精n = 87，ICSI n = 116，受精率59.4%），并导致192次胚胎移植。最终，获得25例妊娠（每次移植妊娠率13.0%），其中4例生化妊娠，7例（33.3%）流产，1例妊娠结局不明，13例活产。在当前文献（n = 27项研究）中，NC-IVF/ICSI周期的妊娠率在10.2%至50%之间。
在我们的研究中，纯NC-IVF/ICSI的妊娠率仍低于15%。尽管这可能与诸如患者年龄>40岁、卵巢储备低或不孕时间长等不利前提条件有关，但仍需要进一步改进以提高妊娠率。
