两年内多次控制性卵巢过度刺激对卵巢储备和反应性的影响：一项回顾性临床研究。

The effects of multiple controlled ovarian hyperstimulation over a 2-year period on ovarian reserve and reactivity: a retrospective clinical study.

作者信息

Bu Xiaomeng, Ma Yanmin, Jia Chanwei, Liu Yanjun, Zhang Qiaoli, Wang Shuyu

机构信息

Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Palliat Med. 2021 Apr;10(4):4391-4397. doi: 10.21037/apm-21-330.

DOI:10.21037/apm-21-330

PMID:33966440

Abstract

BACKGROUND

To evaluate the effects of controlled ovarian hyperstimulation (COH) on ovarian reserve function during in vitro fertilization and embryo transfer (IVF-ET).

METHODS

From August 2018 to August 2020, the medical records of patients who received IVF-ET in the Department of Reproductive Medicine, Beijing Gynaecology and Obstetrics Hospital, Capital Medical University were analyzed retrospectively. Among them, 372 patients received 2 cycles of COH, 54 patients received 3 cycles, and 13 patients received 4 cycles. The levels of follicle-stimulating hormone (FSH), the number of antral follicles, levels of anti-Müllerian hormone (AMH), the total amount of gonadotropin (GN), the time of ovulation induction, the number of eggs obtained, the number of available embryos, and the number of high-quality embryos cycles were compared in different treatment.

RESULTS

The age of female patients did not significantly affect the levels of AMH or FSH during menstruation, nor the number of antral follicles before ovulation induction (P>0.05). However, with an increase in age, an increase in the number of controlled COH cycles was observed. In patients who underwent 2 COH cycles, the number of high-quality embryos in the second cycle increased significantly compared to the first cycle (P<0.05). However, there were no significant differences in the ovulation induction time, the number of eggs, the GN dosage, and the number of available embryos (P>0.05). In patients with 3 treatment cycles, the GN dose used in the third cycle was significantly lower than that used in the first cycle (P<0.05). There were no significant differences in the ovulation induction time, the number of eggs obtained, and the quality of embryos (P>0.05). In patients with 4 treatment cycles, significant differences were observed in the ovulation induction time between the first and the fourth controlled COH cycle (P<0.05). However, no significant differences were detected in GN dosage, ovulation induction time, the number of eggs obtained, the number of available embryos, and the quality of embryos (P>0.05).

CONCLUSIONS

Ovarian reserve function was not significantly affected in patients with up to 4 ovarian stimulation cycles.

摘要

背景

评估体外受精-胚胎移植（IVF-ET）过程中控制性卵巢刺激（COH）对卵巢储备功能的影响。

方法

回顾性分析2018年8月至2020年8月在首都医科大学附属北京妇产医院生殖医学科接受IVF-ET治疗患者的病历。其中，372例患者接受2个周期的COH治疗，54例患者接受3个周期治疗，13例患者接受4个周期治疗。比较不同治疗周期中促卵泡生成素（FSH）水平、窦卵泡数量、抗苗勒管激素（AMH）水平、促性腺激素（GN）总量、排卵诱导时间、获卵数、可用胚胎数及优质胚胎数。

结果

女性患者年龄对月经周期中的AMH或FSH水平以及排卵诱导前的窦卵泡数量均无显著影响（P>0.05）。然而，随着年龄增长，控制性COH周期数增加。接受2个COH周期治疗的患者，第二个周期的优质胚胎数较第一个周期显著增加（P<0.05）。但排卵诱导时间、获卵数、GN用量及可用胚胎数无显著差异（P>0.05）。接受3个治疗周期的患者，第三个周期使用的GN剂量显著低于第一个周期（P<0.05）。排卵诱导时间、获卵数及胚胎质量无显著差异（P>0.05）。接受4个治疗周期的患者，第一个与第四个控制性COH周期的排卵诱导时间存在显著差异（P<0.05）。但GN用量、排卵诱导时间、获卵数、可用胚胎数及胚胎质量无显著差异（P>0.05）。