Sharma V, Riddle A, Mason B A, Pampiglione J, Campbell S
Hallam Medical Centre, London, England.
Fertil Steril. 1988 Mar;49(3):468-78. doi: 10.1016/s0015-0282(16)59775-1.
In the study period (June 1984 to December 1986), 2232 cycles were stimulated in 1294 patients. Ultrasound-directed oocyte recovery (UDOR) was performed as an ambulatory procedure in 1737 (77.8%) cycles, resulting in 1375 embryos transfers (ET). Age, etiology, menstrual cycle length, number of oocytes collected, and number of embryos transferred were important determinants of the outcome. The number of attempts at in vitro fertilization did not affect the clinical pregnancy rate (CPR). In patients receiving four embryos, the CPR appeared to be highest when up to seven embryos were available for transfer. The fertilization rate in an individual cycle had a good prognostic value, the implantation rate being highest when 7 to 9 oocytes were retrieved and greater than 60% of these were fertilized. When 10 or more oocytes were collected, the implantation rate showed a progressive decline, regardless of the fertilization rate. Furthermore, multiple pregnancies failed to occur when greater than 12 oocytes were retrieved or more than eight embryos were available for transfer. These data suggest that, in excessively stimulated cycles, the quality of oocytes and embryos or uterine receptiveness may be suboptimal, and the transfer of more than four embryos is unlikely to increase the success rate.
在研究期间（1984年6月至1986年12月），对1294例患者进行了2232个周期的促排卵治疗。1737个周期（77.8%）采用门诊超声引导下取卵术（UDOR），共进行了1375次胚胎移植（ET）。年龄、病因、月经周期长度、采集的卵母细胞数量以及移植的胚胎数量是结局的重要决定因素。体外受精的尝试次数不影响临床妊娠率（CPR）。在接受4个胚胎移植的患者中，当有多达7个胚胎可供移植时，CPR似乎最高。单个周期的受精率具有良好的预后价值，当获取7至9个卵母细胞且其中超过60%受精时，着床率最高。当采集10个或更多卵母细胞时，无论受精率如何，着床率均呈逐渐下降趋势。此外，当获取超过12个卵母细胞或有超过8个胚胎可供移植时，未发生多胎妊娠。这些数据表明，在过度刺激的周期中，卵母细胞和胚胎的质量或子宫容受性可能欠佳，移植超过4个胚胎不太可能提高成功率。
