Hu Linli, Bu Zhiqin, Guo Yihong, Su Yingchun, Zhai Jun, Sun Yingpu
Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University China.
Int J Clin Exp Med. 2014 Apr 15;7(4):1128-34. eCollection 2014.
Many protocols have been proposed to improve IVF outcomes for poor ovarian responders. The aim of this study was to explore the relationship between age, ovarian hyperstimulation protocol and IVF/ICSI outcomes in poor ovarian responder (POR) according to the Bologna criteria, and to compare the efficacy of different protocols used in PORs undergoing IVF/ICSI. We retrospectively analyzed clinical data of 4875 IVF/ICSI cycles, including 592 cycles of women diagnosed with POR according to Bologna criteria. We explored the association of age, different types of ovarian hyperstimulation protocols and prevalence of POR, IVF/ICSI outcomes. Age, basic FSH, AFC, and as well as ovarian hyperstimulation protocols, were all associated with POR. Irrespective of age, PORs in different ovarian hyperstimulation protocol groups had similar AFC, basic sex hormones, number of retrieved oocyte, implantation rate and clinical pregnancy rate as well. However, PORs treated with mild stimulation protocol used least doses of gonadotropins and shortest days of stimulation compared with those treated with other protocols (P<.05). The current study has shown that age, basic FSH, AFC and ovarian stimulation protocols patients used are all significantly associated with POR according to the Bologna criteria. It seems that there is no difference in clinical outcomes such as clinical pregnancy rate, implantation rate and spontaneous abortion rate between different protocols.
已经提出了许多方案来改善卵巢反应不良患者的体外受精结局。本研究的目的是根据博洛尼亚标准探讨卵巢反应不良(POR)患者的年龄、卵巢过度刺激方案与体外受精/卵胞浆内单精子注射(IVF/ICSI)结局之间的关系,并比较在接受IVF/ICSI的POR患者中使用的不同方案的疗效。我们回顾性分析了4875个IVF/ICSI周期的临床数据,其中包括根据博洛尼亚标准诊断为POR的592例女性的周期。我们探讨了年龄、不同类型的卵巢过度刺激方案与POR患病率、IVF/ICSI结局之间的关联。年龄、基础卵泡刺激素(FSH)、窦卵泡计数(AFC)以及卵巢过度刺激方案均与POR有关。无论年龄如何,不同卵巢过度刺激方案组中的POR患者在AFC、基础性激素、获取的卵母细胞数量、种植率和临床妊娠率方面也相似。然而,与接受其他方案治疗的患者相比,采用温和刺激方案治疗的POR患者使用的促性腺激素剂量最少,刺激天数最短(P<0.05)。当前研究表明,根据博洛尼亚标准,患者的年龄、基础FSH、AFC和使用的卵巢刺激方案均与POR显著相关。不同方案之间在临床妊娠率、种植率和自然流产率等临床结局方面似乎没有差异。