卵巢儲備功能減退的巧囊合并不孕的手術(shù)及輔助生殖治療研究
發(fā)布時間：2019-02-23 20:54
【摘要】：目的：探討卵巢子宮內(nèi)膜異位囊腫(巧囊)伴儲備功能下降行巧囊放液加囊壁電灼繼以輔助生殖治療的臨床效果。 方法： 1.選取2010年2月至2013年6月因卵巢儲備功能下降的巧囊合并不孕的患者42例為實(shí)驗(yàn)組,行腹腔鏡下巧囊切開放液±囊壁電灼術(shù),術(shù)后續(xù)以長方案或者超長方案促排卵行IVF/ICSI治療；以2006年1月至2010年12月行腹腔鏡下巧囊剝除術(shù)后行IVF/ICSI治療的113例患者為對照組。 2.所有入選患者均記錄基礎(chǔ)情況,包括年齡、基礎(chǔ)FSH、基礎(chǔ)E2；促排卵情況,包括周期促性腺激素總量、獲卵數(shù)、獲卵率、受精率、胚胎數(shù)、優(yōu)胚率和臨床妊娠率。 3.比較不同側(cè)別卵巢的反應(yīng)差異和結(jié)局差異,如術(shù)前竇卵泡計數(shù)、術(shù)后竇卵泡計數(shù),可穿刺卵泡數(shù),獲卵數(shù),獲卵率。 結(jié)果：(1)巧囊放液組平均年齡為31.1±3.6歲,對照組為31.6±3.7歲,兩組比較無顯著性差異；巧囊放液組基礎(chǔ)FSH、基礎(chǔ)E2為9.41±4.21IU/L和51.78±26.96ng/L,而對照組為7.86±2.58ng/L和43.42±21.28IU/L,兩組比較有統(tǒng)計學(xué)差異(P0.05)。巧囊放液組周期獲卵數(shù)、周期胚胎數(shù)以及周期促性腺激素總量為5.49±3.72個、3.30±2.52個及2855±765IU,對照組為6.80±4.62個、4.92±3.45個及2174±939IU,巧囊放液組患者周期促性腺激素總量增加,獲卵數(shù)及胚胎數(shù)均較對照組低,兩組比較具有統(tǒng)計學(xué)差異性(P0.05)；巧囊放液組獲卵率、受精率及優(yōu)胚率為65.41%,60.26%和42.37%,對照組為67.42%,64.65%和43.37%,兩組比較差異無顯著性(P0.05)；巧囊放液組起始周期臨床妊娠率40%,對照組45.13%,兩組比較差異無顯著性(P0.05)。(2)不同側(cè)別卵巢比較：巧囊切開放液可平均增加患側(cè)卵巢竇卵泡計數(shù)0.49枚；初發(fā)巧囊行切開放液側(cè)卵巢穿刺卵泡數(shù)及獲卵數(shù)高于囊腫剝除側(cè)；復(fù)發(fā)巧囊切開放液后可穿刺卵泡最少,該側(cè)卵巢獲卵數(shù)最少,但獲卵率相當(dāng)。 結(jié)論：術(shù)前巧囊切開放液+/-囊壁電灼治療組較巧囊剝除組卵巢儲備功能明顯降低,但治療后取得了與對照組無明顯差異的獲卵率、優(yōu)胚率及臨床妊娠率,表明巧囊放液+／-囊壁電灼繼輔助生殖治療是有效的,這樣的術(shù)式可能改善了卵巢儲備功能。
[Abstract]:Objective: to investigate the clinical effect of ovarial endometriosis cyst (OEC) with decline of reserve function. Methods: 1. From February 2010 to June 2013, 42 cases of cysts complicated with infertility due to the decline of ovarian reserve function were selected as experimental group. IVF/ICSI was used to induce ovulation with long or super long protocol. From January 2006 to December 2010, 113 patients with IVF/ICSI were treated by laparoscopic cystectomy. 2. All patients were enrolled to record basic information, including age, basal FSH, basal E2, ovulation promotion, including the total amount of cycle gonadotropin, the number of eggs acquired, the rate of egg acquisition, fertilization rate, number of embryos, the rate of superior embryo and the rate of clinical pregnancy. 3. The differences in response and outcome were compared, such as antral follicle count before operation, antral follicle count after operation, number of punctured follicles and oocyte yield. Results: (1) the average age was 31.1 鹵3.6 years in the dexterous capsule group and 31.6 鹵3.7 years in the control group. There was no significant difference between the two groups. The E _ 2 of basal FSH, was 9.41 鹵4.21IU/L and 51.78 鹵26.96ng / L in the dexterous capsule group, while that in the control group was 7.86 鹵2.58ng/L and 43.42 鹵21.28. There was significant difference between the two groups (P0.05). The number of eggs, the number of embryos and the total number of gonadotropins were 5.49 鹵3.72, 3.30 鹵2.52 and 2855 鹵765IUs in the dexterous capsule group and 6.80 鹵4.62, 4.92 鹵3.45 and 2174 鹵939IUs in the control group, respectively. The total amount of gonadotropin increased, the number of eggs and embryos were lower in the dexterous capsule group than in the control group, and there was statistical difference between the two groups (P0.05). The rate of obtaining eggs, fertilization rate and excellent embryo rate were 65.41% and 42.37% in the dexterous capsule group, 64.65% and 43.37% in the control group, respectively. There was no significant difference between the two groups (P0.05). The clinical pregnancy rate was 40% in the dexterous capsule group and 45.13% in the control group. There was no significant difference between the two groups (P0.05). (2). The average number of antral follicles in the affected side was increased by cystolithotomy and exfoliation (P0.05). (2). The number of punctured follicles and the number of oocytes obtained were higher in the first cleavage and exfoliation side than in the exfoliation side of the cyst, and the number of follicles could be punctured least after the recrudescent cleavage and opening fluid, and the oocyte number was the least in this side, but the rate of obtaining eggs was the same. Conclusion: the ovarian reserve function of the treatment group was significantly lower than that of the cleavage cystectomy group, but there was no significant difference between the treatment group and the control group in oocyte acquisition rate, embryo rate and clinical pregnancy rate. The results showed that the adjuvant reproductive therapy was effective, and the ovarian reserve function might be improved.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.8
本文編號：2429189
[Abstract]:Objective: to investigate the clinical effect of ovarial endometriosis cyst (OEC) with decline of reserve function. Methods: 1. From February 2010 to June 2013, 42 cases of cysts complicated with infertility due to the decline of ovarian reserve function were selected as experimental group. IVF/ICSI was used to induce ovulation with long or super long protocol. From January 2006 to December 2010, 113 patients with IVF/ICSI were treated by laparoscopic cystectomy. 2. All patients were enrolled to record basic information, including age, basal FSH, basal E2, ovulation promotion, including the total amount of cycle gonadotropin, the number of eggs acquired, the rate of egg acquisition, fertilization rate, number of embryos, the rate of superior embryo and the rate of clinical pregnancy. 3. The differences in response and outcome were compared, such as antral follicle count before operation, antral follicle count after operation, number of punctured follicles and oocyte yield. Results: (1) the average age was 31.1 鹵3.6 years in the dexterous capsule group and 31.6 鹵3.7 years in the control group. There was no significant difference between the two groups. The E _ 2 of basal FSH, was 9.41 鹵4.21IU/L and 51.78 鹵26.96ng / L in the dexterous capsule group, while that in the control group was 7.86 鹵2.58ng/L and 43.42 鹵21.28. There was significant difference between the two groups (P0.05). The number of eggs, the number of embryos and the total number of gonadotropins were 5.49 鹵3.72, 3.30 鹵2.52 and 2855 鹵765IUs in the dexterous capsule group and 6.80 鹵4.62, 4.92 鹵3.45 and 2174 鹵939IUs in the control group, respectively. The total amount of gonadotropin increased, the number of eggs and embryos were lower in the dexterous capsule group than in the control group, and there was statistical difference between the two groups (P0.05). The rate of obtaining eggs, fertilization rate and excellent embryo rate were 65.41% and 42.37% in the dexterous capsule group, 64.65% and 43.37% in the control group, respectively. There was no significant difference between the two groups (P0.05). The clinical pregnancy rate was 40% in the dexterous capsule group and 45.13% in the control group. There was no significant difference between the two groups (P0.05). (2). The average number of antral follicles in the affected side was increased by cystolithotomy and exfoliation (P0.05). (2). The number of punctured follicles and the number of oocytes obtained were higher in the first cleavage and exfoliation side than in the exfoliation side of the cyst, and the number of follicles could be punctured least after the recrudescent cleavage and opening fluid, and the oocyte number was the least in this side, but the rate of obtaining eggs was the same. Conclusion: the ovarian reserve function of the treatment group was significantly lower than that of the cleavage cystectomy group, but there was no significant difference between the treatment group and the control group in oocyte acquisition rate, embryo rate and clinical pregnancy rate. The results showed that the adjuvant reproductive therapy was effective, and the ovarian reserve function might be improved.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.8
【參考文獻(xiàn)】
中國期刊全文數(shù)據(jù)庫 前1條
1 馬彩虹;喬杰;陳貴安;張英蘭;楊池蓀;;子宮內(nèi)膜異位癥合并不育中卵泡液腫瘤壞死因子-α的意義[J];中國婦產(chǎn)科臨床雜志;2006年05期
，本文編號：2429189
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