Paulson R J, Sauer M V, Francis M M, Macaso T, Lobo R A
University of Southern California School of Medicine, Los Angeles.
Hum Reprod. 1994 Aug;9(8):1571-5. doi: 10.1093/oxfordjournals.humrep.a138751.
Successful pregnancies have recently been reported in cycles of unstimulated in-vitro fertilization (IVF) which is a simplification of the standard IVF approach utilizing ovarian stimulation. The purpose of this study was to analyse retrospectively the results of the first 3 years of unstimulated IVF cycles at our institution in order to identify factors which predispose these cycles to success or failure. All patients (n = 57) underwent serial monitoring with transvaginal ultrasound and serum oestradiol determinations. Human chorionic gonadotrophin (HCG) 10,000 IU was administered when follicles were felt to be mature and aspiration undertaken (n = 98) 34-36 h later. Among nine patients aged > or = 40 years, 13 aspirations resulted in nine embryo transfers and no pregnancies. In one completed cycle in this group, the patient, who was 42 years old had a baseline follicle stimulating hormone (FSH) concentration of 35.3 mIU/ml. The cycle progressed uneventfully and follicle aspiration yielded two oocytes and two morphologically normal embryos which, however, did not implant. In six patients < 40 years with male factor, seven aspirations yielded 18 oocytes of which 15 were inseminated and did not fertilize. One of the immature oocytes was allowed to mature in vitro and was fertilized and cryopreserved. Its transfer in a subsequent cycle yielded a live birth. Among 78 cycles in 42 patients aged < 40 years without male factor, 63 resulted in embryo transfer with 14% clinical pregnancy rates per aspiration and 17% per embryo transfer. Pregnancy was associated with higher oestradiol concentrations at the time of HCG administration and multiple embryos available for embryo transfer.(ABSTRACT TRUNCATED AT 250 WORDS)
近期有报道称，未刺激的体外受精（IVF）周期中出现了成功妊娠的情况，这是对利用卵巢刺激的标准IVF方法的简化。本研究的目的是回顾性分析我院未刺激IVF周期头3年的结果，以确定使这些周期成功或失败的因素。所有患者（n = 57）均接受经阴道超声和血清雌二醇测定的系列监测。当卵泡被认为成熟时，给予10,000 IU人绒毛膜促性腺激素（HCG），并在34 - 36小时后进行抽吸（n = 98）。在9名年龄≥40岁的患者中，13次抽吸导致9次胚胎移植，无一例妊娠。在该组的一个完整周期中，一名42岁的患者基线促卵泡激素（FSH）浓度为35.3 mIU/ml。周期进展顺利，卵泡抽吸获得2个卵母细胞和2个形态正常的胚胎，但未着床。在6名年龄<40岁的男性因素患者中，7次抽吸获得18个卵母细胞，其中15个进行了授精但未受精。1个未成熟卵母细胞在体外成熟、受精并冷冻保存。其在随后周期的移植产生了活产。在42名年龄<40岁且无男性因素的患者的78个周期中，63个导致胚胎移植，每次抽吸的临床妊娠率为14%，每次胚胎移植的临床妊娠率为17%。妊娠与HCG给药时较高的雌二醇浓度以及可用于胚胎移植的多个胚胎有关。（摘要截断于250字）
