Zhuang Jing, Li Hengli, Li Xiaohong, Tian Dongmei, Yang Dan, Zhu Minghui
School of Medical and Life Science/Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine.
The Second Hospital of West China, Sichuan University; National Center of Birth Defects Monitoring of China; National Office of MCH Surveillance; Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2019 Feb;98(7):e14379. doi: 10.1097/MD.0000000000014379.
Unexpected poor ovarian response (UPOR) is a problem for both clinicians and infertile couples, because our understanding of this situation is limited. This article investigated incidence of UPOR in women <35 years with normal ovarian reserve function with further analysis.This is a retrospective study, which included 567 women who accepted their first IVF-ET/ICSI. Based on the number of oocytes retrieved, clinic pregnancy rate of fresh cycle, and cycle cancellation rate of fresh cycle, the included cycles were divided into three groups namely unexpected poor ovarian response (UPOR) (n = 120), for which number of oocytes retrieved was not more than 6; normal ovarian response (NOR) (n = 223), for which number of oocytes retrieved was between 7 and 12; and unexpected high ovarian response (UHOR) (n = 224), for which the number of oocytes retrieved was 13 at least. The comparisons of clinical outcomes and correlated hormones among groups were carried out.The incidence of UPOR in Chinese women is 21.16%. Patient age (χ = 6.177, P = .0129), basic FSH (χ = 20.585, P < .0001), basic LH (χ = 11.689, P = .0006), and AFC (χ = 8.053, P = .0045) might be helpful for diagnosis of UPOR.The basic evaluation of ovarian function may no longer be simplified into normal and abnormal ovarian reserve function; rather, by using a detailed numerical analysis, such as basal FSH and LH levels, the ovarian response to ovulation induction may be predicted to some extent.
意外卵巢低反应(UPOR)对临床医生和不孕夫妇来说都是一个问题,因为我们对这种情况的了解有限。本文对卵巢储备功能正常的35岁以下女性中UPOR的发生率进行了调查并进一步分析。这是一项回顾性研究,纳入了567名接受首次体外受精-胚胎移植/卵胞浆内单精子注射的女性。根据获卵数、新鲜周期临床妊娠率和新鲜周期取消率,将纳入的周期分为三组,即意外卵巢低反应(UPOR)组(n = 120),其获卵数不超过6个;正常卵巢反应(NOR)组(n = 223),其获卵数在7至12个之间;以及意外卵巢高反应(UHOR)组(n = 224),其获卵数至少为13个。对各组的临床结局和相关激素进行了比较。中国女性中UPOR的发生率为21.16%。患者年龄(χ = 6.177,P = 0.0129)、基础促卵泡生成素(χ = 20.585,P < 0.0001)、基础促黄体生成素(χ = 11.689,P = 0.0006)和窦卵泡计数(χ = 8.053,P = 0.0045)可能有助于UPOR的诊断。卵巢功能的基本评估可能不再简单地分为正常和异常卵巢储备功能;相反,通过使用详细的数值分析,如基础促卵泡生成素和促黄体生成素水平,可以在一定程度上预测卵巢对促排卵的反应。