Universitair Ziekenhuis Brussel, Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, Brussels 1090, Belgium; Sapienza University of Rome, Department of Maternal and Child Health and Urological Sciences, Roma, Italy.
Universitair Ziekenhuis Brussel, Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, Brussels 1090, Belgium; University of Zagreb, Department of Obstetrics and Gynaecology, Zagreb, Croatia.
Reprod Biomed Online. 2020 Aug;41(2):263-270. doi: 10.1016/j.rbmo.2020.03.010. Epub 2020 Apr 11.
Is there an association between ovarian response and perinatal outcomes?
A retrospective, single-centre cohort study including all women undergoing their first ovarian stimulation cycle in a gonadotrophin releasing hormone antagonist protocol, with a fresh embryo transfer that resulted in a singleton live birth from January 2009 to December 2015. Patients were categorized into four groups according to the number of oocytes retrieved: one to three (category 1), four to nine (category 2), 10-15 (category 3), or over 15 oocytes (category 4).
The overall number of patients analysed was 964. No relevant statistical difference was found among neonatal outcomes across the four ovarian response categories. Neonatal weight (in grams) was comparable between all groups (3222 ± 607 versus 3254 ± 537 versus 3235 ± 575 versus 3200 ± 622; P = 0.85, in categories 1, 2, 3 and 4, respectively). No statistically significant differences were found among the ovarian response categories for birth weight z-scores (taking into account neonatal sex and delivery term). The incidence of pre-term birth and low birth weight was comparable across the different ovarian response groups (P = 0.127 and P = 0.19, respectively). Finally, the occurrence of adverse obstetric outcomes did not differ among the ovarian response categories. Multivariate regression analysis revealed that the number of oocytes was not associated with neonatal birth weight.
No association was found between ovarian response and adverse perinatal outcomes in antagonist IVF and intracytoplasmic sperm injection cycles. Future, larger scale and prospectively designed investigations are needed to validate these results.
卵巢反应与围产结局之间是否存在关联？
一项回顾性、单中心队列研究，纳入了 2009 年 1 月至 2015 年 12 月期间采用促性腺激素释放激素拮抗剂方案进行首次卵巢刺激周期且有新鲜胚胎移植、单胎活产的所有女性患者。根据获卵数将患者分为 4 组：1-3 枚（第 1 组）、4-9 枚（第 2 组）、10-15 枚（第 3 组）或超过 15 枚（第 4 组）。
共分析了 964 例患者。4 个卵巢反应组之间的新生儿结局无显著统计学差异。各组间新生儿体重（克）相似（分别为 3222±607 克、3254±537 克、3235±575 克和 3200±622 克；P=0.85）。考虑到新生儿性别和分娩时胎龄，卵巢反应组间出生体重 z 评分也无显著统计学差异。不同卵巢反应组间早产和低出生体重的发生率相似（P=0.127 和 P=0.19）。此外，不同卵巢反应组间不良产科结局的发生率无差异。多变量回归分析显示，获卵数与新生儿出生体重无关。
在拮抗剂 IVF 和卵胞浆内单精子注射周期中，卵巢反应与不良围产结局之间无关联。需要更大规模和前瞻性设计的研究来验证这些结果。
