在 GnRH 拮抗剂方案的新鲜周期中，刺激时间对低反应者和正常反应者的卵母细胞成熟和妊娠结局的不同影响。

The different impact of stimulation duration on oocyte maturation and pregnancy outcome in fresh cycles with GnRH antagonist protocol in poor responders and normal responders.

机构信息

Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.

Department of Obstetrics & Gynecology, Shin Kong Memorial Wu Ho-Su Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2019 Jul;58(4):471-476. doi: 10.1016/j.tjog.2019.05.007.

DOI:10.1016/j.tjog.2019.05.007

PMID:31307735

Abstract

OBJECTIVE

To study the impact of stimulation duration on intracytoplasmic sperm injection (ICSI) - embryo transfer (ET) outcome in poor and normal responders during controlled ovarian stimulation using gonadotropin-releasing hormone (GnRH) antagonist protocol.

MATERIALS AND METHODS

This is a retrospective cohort study. There were 1481 women undergoing ICSI-ET cycles. Women with ovum pick-up number ≤3 were defined as poor responders (n = 235), and those with a number ≥4 were normal responders (n = 1246).

RESULTS

The mean stimulation duration was shorter in poor responders with pregnancy group as compared with normal responders with pregnancy group (7.8 ± 2.2 vs. 9.2 ± 1.6 days, p < 0.01). Poor responders with a shortest stimulation duration (≤6 days) appeared a higher live birth rate (≤6 days: 33.3%, 7-8 days: 20.0%, 9-10 days: 15.9%, and ≥11 days: 11.1%, p = 0.18). Normal responders with a shortest stimulation duration (≤6 days) appeared a lowest live birth rate (≤6 days: 28.6%, 7-8 days: 35.8%, 9-10 days: 33.6%, and ≥11 days: 29.3%, p = 0.61). Oocyte maturation rate was significantly lower at stimulation durations ≤6 days group (≤6 days: 67%, 7-8 days: 80%, 9-10 days: 85%, and ≥11 days: 87%, p = 0.02) in normal responders.

CONCLUSION

In ICSI-ET cycles, stimulation duration appears to have different impact on oocyte maturation, clinical pregnancy rates and live birth rates in both poor and normal responders.

摘要

目的

研究在使用促性腺激素释放激素（GnRH）拮抗剂方案进行控制性卵巢刺激时，刺激持续时间对卵胞浆内单精子注射（ICSI）-胚胎移植（ET）结局的影响，分别在卵巢反应不良和正常的患者中进行研究。

材料和方法

这是一项回顾性队列研究。共纳入 1481 例接受 ICSI-ET 周期的患者。取卵数≤3 定义为卵巢反应不良（n=235），取卵数≥4 定义为卵巢反应正常（n=1246）。

结果

与妊娠组的正常反应者相比，妊娠组的卵巢反应不良者的平均刺激持续时间更短（7.8±2.2 天 vs. 9.2±1.6 天，p<0.01）。刺激持续时间最短（≤6 天）的卵巢反应不良者的活产率更高（≤6 天：33.3%，7-8 天：20.0%，9-10 天：15.9%，≥11 天：11.1%，p=0.18）。刺激持续时间最短（≤6 天）的正常反应者的活产率最低（≤6 天：28.6%，7-8 天：35.8%，9-10 天：33.6%，≥11 天：29.3%，p=0.61）。正常反应者中，刺激持续时间≤6 天组的卵母细胞成熟率显著降低（≤6 天：67%，7-8 天：80%，9-10 天：85%，≥11 天：87%，p=0.02）。