本文選題：卵巢功能減退 + 自然周期��； 參考：《生殖醫(yī)學(xué)雜志》2016年10期

【摘要】：目的探討卵巢功能減退患者,采用自然周期或微刺激周期體外受精(IVF)/卵胞漿內(nèi)單精子注射(ICSI)治療的臨床參數(shù)(獲卵率、受精率、妊娠率),為臨床治療提供依據(jù)。方法從本生殖中心CCRM數(shù)據(jù)庫中選取6 632例卵巢功能減退患者的臨床資料,其中自然周期2 253例,微刺激周期4 379例,在月經(jīng)第3天B超監(jiān)測竇卵泡數(shù)目、直徑,檢查基礎(chǔ)FSH、LH、E2值。竇卵泡直徑8mm,FSH16U/L、E2280pmol/L的患者,采用克羅米芬/加HMG微刺激促排卵,否則行自然周期。當(dāng)優(yōu)勢卵泡直徑15mm,平均每個(gè)優(yōu)勢卵泡E2約等于1 100pmol/L時(shí),于當(dāng)天20:30肌肉注射0.1mg GnRH激動(dòng)劑(GnRH-a)誘發(fā)排卵,34~36h后取卵。在內(nèi)膜達(dá)8~14mm時(shí)行新鮮胚胎移植,否則行胚胎的玻璃化冷凍,待以后行自然周期移植。結(jié)果自然周期或微刺激IVF/ICSI治療時(shí),卵巢功能減退患者的每移植周期妊娠率為30%左右,隨著治療次數(shù)的增加,妊娠率沒有明顯改變,連續(xù)4周期累計(jì)妊娠率約46%。結(jié)論卵巢功能減退患者在自然周期/微刺激治療中,妊娠率沒有隨著治療次數(shù)的增加而下降,建議連續(xù)采用自然周期/微刺激治療,節(jié)約治療時(shí)間、提高累積妊娠率。年齡45歲的不孕癥患者應(yīng)適時(shí)終止自然周期/微刺激治療,或改用供卵IVF治療。
[Abstract]:Objective to investigate the clinical parameters (oocyte acquisition rate, fertilization rate and pregnancy rate) in patients with ovarian dysfunction treated by IVFFU / ICSI during natural or microstimulation cycles, and to provide evidence for clinical treatment. Methods the clinical data of 6 632 patients with ovarian dysfunction were selected from CCRM database of the reproductive center, including 2 253 cases of natural cycle and 4 379 cases of microstimulation cycle. The number and diameter of antral follicles were monitored by B ultrasound on the 3rd day of menstruation. Patients with antral follicle diameter of 8mm FSH 16U / L FSH / L 2280pmol / L were treated with clomiphene / HMG microstimulation to induce ovulation, otherwise, natural cycles were performed. When the diameter of dominant follicle was 15mm and the average E _ 2 of each dominant follicle was about 1 100pmol / L, the ovulation was induced by intramuscular injection of 0.1mg GnRH agonist GnRH-a at 20:30 on the same day for 3436 hours. Fresh embryo transfer was performed at endodal 8~14mm, otherwise vitrification of embryo was performed, and then natural cycle transfer was performed. Results during the treatment of IVF / ICSI, the pregnancy rate of the patients with ovarian dysfunction was about 30% per transplant cycle. With the increase of treatment times, the pregnancy rate did not change significantly, and the cumulative pregnancy rate for 4 consecutive cycles was about 46.1%. Conclusion the pregnancy rate does not decrease with the increase of treatment times in patients with ovarian dysfunction. It is suggested that the treatment of natural cycle / microstimulation should be used continuously to save the treatment time and increase the cumulative pregnancy rate. 45-year-old infertility patients should terminate the natural cycle / microstimulation therapy or switch to IVF therapy.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院生殖醫(yī)學(xué)科;
【基金】：江蘇省婦幼保健重點(diǎn)人才FRC201307
【分類號(hào)】：R714.8

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬延敏;賈嬋維;蘭永連;余蘭;周麗穎;王樹玉;;自然周期夫精宮腔內(nèi)人工授精的相關(guān)因素分析[J];中國優(yōu)生與遺傳雜志;2011年08期

2 苗本郁,周燦權(quán),方叢,莊廣倫;自然周期冷凍胚胎解凍移植臨床分析[J];中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版);2005年05期

3 周莉;張波;馮貴雪;李翠明;;自然周期體外受精-胚胎移植在輔助生殖技術(shù)中的應(yīng)用[J];中國優(yōu)生與遺傳雜志;2009年12期

4 陳莉;劉琦;;自然周期和促排周期宮腔內(nèi)人工授精結(jié)果的比較[J];中華男科學(xué)雜志;2009年12期

5 何玲;劉風(fēng)華;龍曉林;張偉良;杜紅姿;;自然周期與人工周期方案凍融胚胎移植結(jié)局比較[J];中國實(shí)用婦科與產(chǎn)科雜志;2009年09期

6 劉金勇;王Z，

本文編號(hào)：2042267