可利用卵母细胞率作为控制性卵巢刺激中临床妊娠结局的预测指标：7933个周期的回顾性分析

Available Oocytes rate as a predictor of clinical pregnancy outcomes in controlled ovarian stimulation: A retrospective analysis of 7933 Cycles.

作者信息

Lin Peiyang, Li Rongshan, Zhu Suqin, Zheng Xiuqiong, Xu Huiling, Zheng Beihong

机构信息

Peiyang Lin Fujian Obstetrics and Gynecology Hospital, Fuzhou, Fujian Province, China.

Rongshan Li Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, Fujian Province 350001, China.

出版信息

Pak J Med Sci. 2024 Dec;40(11):2485-2494. doi: 10.12669/pjms.40.11.10094.

DOI:10.12669/pjms.40.11.10094

PMID:39634878

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11613380/

Abstract

OBJECTIVE

Controlled ovarian stimulation (COS) and embryo culture may affect the development and maturation of oocytes obtained by assisted reproduction technologies (ART). This study used the concept of available oocytes rate (AOR) to evaluate the effect of COS and to identify factors that influence oocyte development and clinical pregnancy (CP).

METHODS

Medical data of 7933 patients who underwent oocyte retrieval and ART treatments was retrospectively reviewed at Fujian Provincial Maternity and Children's Hospital from January 2013 to December 2019. Baseline characteristics of patients, concentrations of hormones, as well as endometrial thickness, number of aspirated follicles, retrieved and available oocytes, and CP rates, were analyzed.

RESULTS

Univariate and multivariate analyses showed that basal estradiol (E2) (OR=0.98, p=0.04), endometrial thickness on human chorionic gonadotropin (hCG)-day (OR=1.25, p<0.01), number of follicles aspirated (OR=1.58, p<0.01), oocytes retrieved (OR=0.80, p=0.04), available oocytes (OR=0.48, p=0.04) and AOR (OR=1.18, p<0.01) contributed to CP. The receiver operating characteristic (ROC) curve for the CP rates showed a possible cutoff for the AOR (area under the curve (AUC)=0.788, cut off=34.13%). All 103 cycles with an AOR less than 34% were then selected as Group-A, and 103 cycles were selected as Group-C by 1:1 case-control matching. The human menopausal gonadotropin (HMG) dose was significantly different between Group-A and Group-C (1064.00±1042.01 U vs. 675.00±691.67 U, respectively, p=0.006). The duration of HMG usage was 7.88±4.73 days in Group-A and 5.79±3.59 days in Group-C (p=0.014).

CONCLUSIONS

The AOR is an important indicator of oocyte function and is correlated with clinical pregnancy outcomes of fresh cycles. The AOR could objectively predict HMG as a clinically related factor that affected the number and maturation of oocytes for insemination.

摘要

目的

控制性卵巢刺激（COS）和胚胎培养可能会影响通过辅助生殖技术（ART）获得的卵母细胞的发育和成熟。本研究采用可用卵母细胞率（AOR）的概念来评估COS的效果，并确定影响卵母细胞发育和临床妊娠（CP）的因素。

方法

回顾性分析了2013年1月至2019年12月在福建省妇幼保健院接受卵母细胞采集和ART治疗的7933例患者的医疗数据。分析了患者的基线特征、激素浓度、子宫内膜厚度、抽吸卵泡数、获取和可用卵母细胞数以及CP率。

结果

单因素和多因素分析显示，基础雌二醇（E2）（OR=0.98，p=0.04）、人绒毛膜促性腺激素（hCG）日的子宫内膜厚度（OR=1.25，p<0.01）、抽吸卵泡数（OR=1.58，p<0.01）、获取的卵母细胞数（OR=0.80，p=0.04）、可用卵母细胞数（OR=0.48，p=0.04）和AOR（OR=1.18，p<0.01）对CP有影响。CP率的受试者工作特征（ROC）曲线显示AOR可能存在一个临界值（曲线下面积（AUC）=0.788；临界值=34.13%）。然后将所有AOR小于34%的103个周期选为A组，并通过1:1病例对照匹配选择103个周期作为C组。A组和C组之间人绝经期促性腺激素（HMG）剂量有显著差异（分别为1064.00±1042.01 U和675.00±691.67 U，p=0.006）。A组HMG使用时间为7.88±4.73天，C组为5.79±3.59天（p=0.014）。