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与类似的自体体外受精周期相比,供体卵母细胞周期的妊娠率:对辅助生殖技术协会的26457个新鲜周期的分析。

Pregnancy rates in donor oocyte cycles compared to similar autologous in vitro fertilization cycles: an analysis of 26,457 fresh cycles from the Society for Assisted Reproductive Technology.

作者信息

Yeh Jason S, Steward Ryan G, Dude Annie M, Shah Anish A, Goldfarb James M, Muasher Suheil J

机构信息

Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina.

University Hospitals Fertility Center, Beachwood, Ohio.

出版信息

Fertil Steril. 2014 Aug;102(2):399-404. doi: 10.1016/j.fertnstert.2014.04.027. Epub 2014 May 17.

Abstract

OBJECTIVE

To use a large US IVF database and compare pregnancy outcomes in fresh donor oocyte versus autologous IVF cycles in women age 20-30 years.

DESIGN

Retrospective cohort study.

SETTING

Not applicable.

PATIENT(S): Women undergoing fresh autologous ovarian stimulation, and oocyte donors and recipients in the United States between 2008 and 2010.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Implantation, clinical pregnancy (CP), and live birth (LB) rates.

RESULT(S): Despite similar demographics, stimulation, and embryo parameters, donor oocyte recipients had significantly higher rates of implantation, CP, and LB compared to those undergoing fresh autologous cycles. Odds ratios for implantation, CP, and LB significantly favored the donor oocyte group in all comparisons, including those limited to intracytoplasmic sperm injection cycles, intracytoplasmic sperm injection with male factor, unexplained infertility, cleavage stage embryo transfer, blastocyst transfer, elective single blastocyst transfer, and autologous patients with prior tubal ligation.

CONCLUSION(S): Recent US data suggest that the hormonal environment resulting from autologous ovarian stimulation lowers IVF success rates. Further research is needed to determine when to avoid fresh embryo transfer in autologous patients.

摘要

目的

利用一个大型美国体外受精数据库,比较20至30岁女性新鲜供体卵母细胞与自体体外受精周期的妊娠结局。

设计

回顾性队列研究。

地点

不适用。

患者

2008年至2010年间在美国接受新鲜自体卵巢刺激的女性,以及卵母细胞供体和受体。

干预措施

无。

主要观察指标

着床率、临床妊娠(CP)率和活产(LB)率。

结果

尽管人口统计学、刺激和胚胎参数相似,但与接受新鲜自体周期的患者相比,供体卵母细胞受体的着床率、临床妊娠率和活产率显著更高。在所有比较中,着床、临床妊娠和活产的优势比均显著有利于供体卵母细胞组,包括仅限于卵胞浆内单精子注射周期、伴有男性因素的卵胞浆内单精子注射、不明原因不孕、卵裂期胚胎移植、囊胚移植、选择性单囊胚移植以及既往有输卵管结扎史的自体患者。

结论

美国近期的数据表明,自体卵巢刺激产生的激素环境会降低体外受精成功率。需要进一步研究以确定自体患者何时应避免新鲜胚胎移植。

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