Kutlu Tayfun, Özkaya Enis, Kumru Pınar, Ayvacı Habibe, Devranoğlu Belgin, Sanverdi İlhan, Şahin Yavuz, Sağlam Beyhan, Karateke Ateş
Zeynep Kamil Maternity and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2017 Mar;14(1):58-63. doi: 10.4274/tjod.04382. Epub 2017 Mar 15.
To determine some major characteristic differences between two consecutive successful and unsuccessful intracytoplasmic sperm injection (ICSI) cycles in poor responders.
Sixty women with poor ovarian response as determined using the Bologna criteria underwent ICSI cycles following an unsuccessful trial. Some parameters of both cycles including age, body mass index (BMI), serum follicle-stimulating hormone (FSH) and estradiol levels, antral follicle count, gonadotropin dosage, duration of stimulation, antagonist starting day, duration of antagonist administration, endometrial thickness at trigger day, number of total and fertilized oocytes, embryo transfer day, number of embryo cells, and fertilization rate were compared in the same patients to identify predictors of cycles with clinical pregnancy.
The mean age, BMI, serum FSH, estradiol concentrations, and antral follicle count were 35.9 years (range, 30-42 years), 25.9 kg/m (range, 18.4-33.5 kg/m), 10.9 IU/mL (range, 7-13 IU/mL), 52.9 pg/mL (range, 11.6-75 pg/mL), and 4.7 (range, 2-10), respectively. A comparison of cycle characteristics showed a significantly higher total number of mature and fertilized oocytes in successful cycles. The fertilization rate was also significantly higher in cycles with clinical pregnancy. Early initiation of antagonist was shown to result in favorable outcomes. A comparison of embryo characteristics showed that transfer of higher-stage embryos and embryos with higher numbers of cells had a significant impact on cycle outcomes.
Our comparison of parameters of failed and successful ICSI cycles in poor responders revealed significantly earlier antagonist initiation, higher total number of mature and fertilized oocytes, fertilization rate, and significantly higher stage of embryo development and cell numbers at transfer in cycles that resulted in clinical pregnancy.
确定反应不良患者连续两个成功与失败的卵胞浆内单精子注射（ICSI）周期之间的一些主要特征差异。
60名根据博洛尼亚标准确定为卵巢反应不良的女性在一次不成功的尝试后接受了ICSI周期治疗。在同一患者中比较两个周期的一些参数，包括年龄、体重指数（BMI）、血清促卵泡激素（FSH）和雌二醇水平、窦卵泡计数、促性腺激素剂量、刺激持续时间、拮抗剂开始日、拮抗剂给药持续时间、扳机日的子宫内膜厚度、总卵母细胞数和受精卵母细胞数、胚胎移植日、胚胎细胞数以及受精率，以确定临床妊娠周期的预测因素。
平均年龄、BMI、血清FSH、雌二醇浓度和窦卵泡计数分别为35.9岁（范围30 - 42岁）、25.9 kg/m（范围18.4 - 33.5 kg/m）、10.9 IU/mL（范围7 - 13 IU/mL）、52.9 pg/mL（范围11.6 - 75 pg/mL）和4.7（范围2 - 10）。周期特征比较显示，成功周期中成熟和受精卵母细胞的总数显著更高。临床妊娠周期的受精率也显著更高。结果表明，早期开始使用拮抗剂可带来良好结局。胚胎特征比较显示，移植更高阶段的胚胎和细胞数量更多的胚胎对周期结局有显著影响。
我们对反应不良患者失败和成功的ICSI周期参数进行比较后发现，在导致临床妊娠的周期中，拮抗剂启动明显更早，成熟和受精卵母细胞总数、受精率显著更高，胚胎发育阶段和移植时的细胞数量也显著更高。
