本文選題：卵巢過度刺激綜合征 + 體外受精-胚胎移植�。� 參考：《河北醫(yī)科大學》2017年碩士論文

【摘要】：目的:本研究主要是探討除外PCOS的OHSS高風險人群分別全胚冷凍后首次凍融胚胎移植(FET)與新鮮胚胎移植后兩組患者的OHSS發(fā)生率、臨床及實驗室相關指標和臨床結局是否有差異。方法:研究對象為2014年1月-2015年12月于河北醫(yī)科大學第二醫(yī)院生殖醫(yī)學科接受IVF/ICSI助孕患者,且為除外PCOS的OHSS高風險人群。依據(jù)移植方式分為新鮮胚胎移植組和全胚冷凍首次凍融胚胎移植組。通過收集臨床及實驗室數(shù)據(jù),比較兩組患者在接受COH治療后相關實驗室、臨床指標及妊娠結局。結果:1一般情況基礎竇卵泡數(shù):凍融胚胎移植組顯著性高于新鮮胚胎移植組(P=0.000)。余一般情況,兩組比較無顯著性差異(P0.05)。2促排卵期間參數(shù)比較Gn起步計量及應用天數(shù):凍融胚胎移植組顯著性低于新鮮胚胎移植組(P=0.014,P=0.030)。HCG日E2、P水平:凍融胚胎移植組顯著性高于新鮮胚胎移植組(P=0.000,P=0.000)3體外受精情況比較平均獲卵數(shù)、平均可移植胚胎數(shù):凍融胚胎移植組顯著性高于新鮮胚胎移植組(P=0.000,P=0.000)。Gn/N比較:凍融胚胎移植組顯著性低于新鮮胚胎移植組(P=0.000)。4臨床結局平均出生嬰兒體重、雙胎嬰兒平均體重:凍融胚胎移植組顯著性高于新鮮胚胎移植組(P=0.044,P=0.001)臨床妊娠率、流產(chǎn)率、早產(chǎn)率等A、B兩組無顯著性差異。5并發(fā)癥中重度OHSS發(fā)生率:凍融胚胎移植組低于新鮮胚胎移植組,但兩組間無顯著性差異(P=0.38)6 Logistic回歸分析影響妊娠率與OHSS發(fā)病率的相關因素通過Logistic回歸結論得出影響本中心OHSS高危人群妊娠成功率的主要因素是獲卵數(shù)。由于OHSS發(fā)病率低、本次試驗樣本量小,未獲得影響OHSS發(fā)病率的影響因素。結論:1 OHSS高危人群全胚冷凍有利于降低OHSS發(fā)生率,但不影響妊娠率。2全胚冷凍復蘇周期胚胎移植患者的子代體重增加,提示凍胚移植對子代更有利,尚需進一步擴大樣本量。
[Abstract]:Objective: this study was to investigate the OHSS incidence, clinical and laboratory indicators and clinical outcomes of patients with high risk of OHSS except PCOS in the first frozen thawed embryo transfer (FETT) group and the fresh embryo transfer group (FET). Methods: the subjects of the study were IVF / ICSI assisted pregnancy patients who received IVF / ICSI from January 2014 to December 2015 in the Department of Reproductive Medicine, second Hospital of Hebei Medical University, and OHSS high-risk population excluding PCOS. It was divided into fresh embryo transfer group and whole embryo freeze thawed embryo transfer group. By collecting clinical and laboratory data, the laboratory, clinical indexes and pregnancy outcome were compared between the two groups after COH treatment. Results the number of basic antral follicles was significantly higher in the frozen-thawed embryo transfer group than in the fresh embryo transfer group. In general, There was no significant difference between the two groups in the comparison of parameters during ovulation promotion period: the number of days of initial measurement and application of Gn: the level of E2P in frozen thawed embryo transfer group was significantly lower than that in fresh embryo transfer group. HCG day E2P level was significantly higher in frozen and thawed embryo transfer group than in fresh embryo transfer group. In the embryo transfer group, the average number of eggs obtained was compared with that of in vitro fertilization. The average number of embryos transfered: the average birth weight of frozen thawed embryo transfer group was significantly higher than that of fresh embryo transfer group, compared with that of fresh embryo transfer group (P 0.000). Gn / N comparison showed that the clinical outcome of frozen and thawed embryo transfer group was significantly lower than that of fresh embryo transfer group (P = 0.000), and the mean birth weight of clinical outcome was lower in frozen thawed embryo transfer group than that in fresh embryo transfer group. The average body weight of twin infants was significantly higher in frozen thawed embryo transfer group than that in fresh embryo transfer group. There was no significant difference in the rate of premature delivery between the two groups. 5 the incidence of moderate and severe OHSS complications in the frozen-thawed embryo transfer group was lower than that in the fresh embryo transfer group. But there was no significant difference between the two groups. Logistic regression analysis showed that the main factor influencing the success rate of pregnancy in the high risk population of OHSS was the number of eggs. Because of the low incidence of OHSS and the small sample size, no factors affecting the incidence of OHSS were obtained. Conclusion cryopreservation of whole embryo in the high risk population of 1 / 1 OHSS is beneficial to reduce the incidence of OHSS, but it does not affect the weight gain of the offspring of embryo transfer in the whole embryo cryopreservation resuscitation cycle of pregnancy rate .2, suggesting that frozen embryo transplantation is more beneficial to the offspring, and the sample size needs to be further expanded.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714.8

【參考文獻】

相關期刊論文 前2條

1 梁衛(wèi)華,陳士嶺,邢福祺;血管內(nèi)皮生長因子在預測卵巢過度刺激綜合征中的作用[J];中華婦產(chǎn)科雜志;2001年11期

2 李文,金鳴,李金榮,路彤,陳鐵軍;血小板活化因子對培養(yǎng)人臍靜脈血管內(nèi)皮細胞損傷作用的探討[J];中國病理生理雜志;2000年07期

，

本文編號：2037128