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目的 探讨卵巢储备正常的不孕女性实施体外受精-胚胎移植(IVF-ET)时低获卵数的高危因素。方法 收集2019年1月至2021年10月于我院生殖医学科行IVF-ET的49例卵巢储备正常、控制性卵巢刺激(COS)后获卵数<4枚的不孕女性为低获卵组，采用1:3比例配对同一时间段行IVF-ET治疗的卵巢储备正常且获卵数>8枚的不孕患者147例为正常获卵组。比较两组患者的基本资料、既往病史、促排卵情况，并通过多因素回归分析影响卵巢储备正常患者获卵数低的主要影响因素。结果 两组患者的年龄、月经周期、基础LH(bLH)、基础窦卵泡计数(AFC)、抗苗勒管激素(AMH)均无显著性差异(P>0.05);低获卵组的体质量指数(BMI)显著高于正常获卵组[(25.71±4.37)kg/m2 vs.(22.98±3.55) kg/m2](P<0.05),基础FSH(bFSH)亦显著高于正常获卵组[(7.23±2.09)U/L vs.(6.67±1.45) U/L](P<0.05)。两组患者既往妊娠史、宫腔手术史、不孕因素比例均无统计学差异(P>0.05),低获卵组盆腔手术史比例显著高于正常获卵组(36.73%vs.17.01%)(P<0.05)。两组患者促排卵实验室指标比较均无显著性差异(P>0.05)。多因素回归分析结果显示，高BMI和盆腔手术史是卵巢储备正常患者获卵数<4枚的主要危险因素(P<0.05)。结论 高BMI和盆腔手术史是卵巢储备正常患者COS后低获卵数的危险因素，临床实践中应关注不孕症患者的体重控制和既往病史的综合评估。
Abstract：Objective:To investigate high risk factors of low oocyte retrieval in infertile women with normal ovarian reserve undergoing IVF-ET.Methods:Forty-nine infertile women with normal ovarian reserve who received IVF-ET and retrieved less than 4 oocytes during control ovarian stimulation(COS) from Jan. 2019 to Oct. 2021 in our hospital were collected as low oocyte retrieval group. During same period, 147 infertile patients with normal ovarian reserve and retrieved more than 8 oocytes were matched in a ratio of 1:3 as normal oocyte retrieval group. The basic data, past medical history and ovulation induction of the two groups were compared, and the main factors affecting the low oocyte retrieval in patients with normal ovarian reserve were analyzed by multivariate regression.Results:There were no significant differences in age, menstrual cycle, basic LH(bLH),basic antral follicle count(AFC) and anti-Müllerian hormone(AMH) between the two groups(P>0.05). The body mass index(BMI) of low oocyte retrieval group was significantly higher than that of normal oocyte retrieval group[(25.71±4.37) kg/m2 vs.(22.98±3.55) kg/m2](P<0.05),and basic FSH was also significantly higher than that of normal oocyte retrieval group[(7.23±2.09) U/L vs.(6.67±1.45) U/L](P<0.05). There were no significant differences in the history of previous pregnancy, uterine cavity operation and the proportion of infertility factors between the two groups(P>0.05). The proportion of pelvic surgery history in low oocyte retrieval group was significantly higher than that in normal oocyte retrieval group(36.73% vs.17.01%)(P<0.05). There was no significant difference in laboratory indexes of ovulation induction between the two groups(P>0.05). Multivariate analysis showed that high BMI and pelvic surgery history were the main risk factors for number of oocyte retrieval less than 4 in the patients with normal ovarian reserve.Conclusions:High BMI and pelvic surgery history are the main risk factors for low oocyte retrieval after controlled ovarian stimulation in patients with normal ovarian reserve. In clinical practice, attention should be paid to weight control and comprehensive evaluation of previous medical history in infertile patients.
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基本信息:
中图分类号:R714.8
引用信息:
[1]卜晓萌,刘艳君,周丽颖,等.卵巢储备正常不孕女性低获卵数的高危因素分析[J].生殖医学杂志,2022,31(06):777-781.
2022-06-15
2022-06-15