Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China.
Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China; Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China.
Fertil Steril. 2023 Jun;119(6):985-993. doi: 10.1016/j.fertnstert.2023.02.011. Epub 2023 Feb 19.
To study the effects of unexpected follicular development and ovulation in artificial cycles (ACs) on pregnancy outcomes.
A retrospective cohort study.
A university-affiliated fertility center.
PATIENT(S): A total of 1,427 patients who underwent a single, frozen-thawed blastocyst transfer with AC regimens from January 2014 to December 2020 at a university-affiliated fertility center were included.
INTERVENTION(S): Unexpected follicular development and ovulation in ACs.
MAIN OUTCOME MEASURE(S): Live birth rate (LBR), biochemical pregnancy rate, clinical pregnancy rate, and ongoing pregnancy rate.
RESULT(S): A total of 161 patients with unexpected follicular development and ovulation in ACs (ovulation group) and 1,266 patients without growing follicles in ACs (control group) were enrolled. The patients in the ovulation group were older and had higher levels of serum follicle-stimulating hormone and lower levels of serum antimüllerian hormone. After propensity score matching, the baseline characteristics between the 2 groups were comparable and no significant difference was observed in the LBR (ovulation group, 39.0% vs. control group, 39.0%), biochemical pregnancy rate (ovulation group, 60.3% vs. control group, 58.2%), clinical pregnancy rate (ovulation group, 53.4% vs. control group, 50.7%), or ongoing pregnancy rate (ovulation group, 42.5% vs. control group, 40.4%). Moreover, the patients in the ovulation group showed a lower risk of hypertensive disorders of pregnancy (HDP) (1.6% vs. 15.3%). A subgroup analysis of women who delivered singleton live-born babies also demonstrated that unexpected follicular development and ovulation in ACs was associated with a decreased risk of HDP (adjusted odds ratio, 0.070; 95% confidence interval, 0.007-0.712) and an increased risk of large-for-gestational-age infants (adjusted odds ratio, 4.046; 95% confidence interval, 1.319-12.414).
CONCLUSION(S): Women with unexpected follicular development and ovulation during single frozen-thawed blastocyst transfer with AC regimens had a similar LBR and a reduced risk of HDP compared with those with routine AC regimens, and singleton neonates had an increased risk of being large for gestational age.
研究人工周期（AC）中意外卵泡发育和排卵对妊娠结局的影响。
回顾性队列研究。
一所大学附属生育中心。
纳入 2014 年 1 月至 2020 年 12 月在一所大学附属生育中心接受单次冷冻胚胎移植的 1427 名患者，这些患者均接受 AC 方案治疗。
AC 中意外的卵泡发育和排卵。
活产率（LBR）、生化妊娠率、临床妊娠率和持续妊娠率。
共纳入 161 例 AC 中出现意外卵泡发育和排卵的患者（排卵组）和 1266 例 AC 中无卵泡生长的患者（对照组）。排卵组患者年龄较大，血清卵泡刺激素水平较高，血清抗苗勒管激素水平较低。经过倾向评分匹配后，两组患者的基线特征无显著差异，LBR（排卵组，39.0% vs. 对照组，39.0%）、生化妊娠率（排卵组，60.3% vs. 对照组，58.2%）、临床妊娠率（排卵组，53.4% vs. 对照组，50.7%）和持续妊娠率（排卵组，42.5% vs. 对照组，40.4%）无显著差异。此外，排卵组患者发生妊娠高血压疾病（HDP）的风险较低（1.6% vs. 15.3%）。对分娩单胎活产婴儿的患者进行亚组分析也表明，AC 中意外的卵泡发育和排卵与 HDP 风险降低相关（调整后的优势比，0.070；95%置信区间，0.007-0.712），巨大儿的风险增加（调整后的优势比，4.046；95%置信区间，1.319-12.414）。
与常规 AC 方案相比，在接受 AC 方案的单次冷冻胚胎移植中出现意外卵泡发育和排卵的女性具有相似的 LBR 和降低的 HDP 风险，单胎新生儿发生巨大儿的风险增加。
