获卵数与IVF/ICSI累积活产率的相关性研究

摘要

目的 探讨获卵数与IVF/ICSI累积活产率的相关性. 方法 回顾性分析2014年4月1日至2015年6月31日因不孕症在我院生殖中心首次IVF/ICSI助孕的4 975例患者.根据获卵数的不同将患者分为6组:A组(1～3枚);B组(4～6枚);C组(7～9枚);D组(10～15枚);E组(16～20枚);F组(＞20枚).比较各组间年龄、不孕因素、2PN率、累积活产率及因OHSS倾向全胚冷冻等的差异,并对获卵数、年龄、促排卵方案等对累积活产率的影响进行Logistic多因素分析. 结果 随着获卵数的增加,累积活产率及因OHSS倾向全胚冷冻率显著增加,组间差异均具有统计学意义(P＜0.05);F组2PN率、新鲜移植周期占比显著低于其它5组(P＜0.05);A组新鲜周期移植的活产率显著低于其它组(P＜0.05),无可移植胚胎周期显著高于其它组(P＜0.05).Logistic多因素分析表明:与获卵数A组相比,B～F组活产的概率显著增加,OR值分别为3.456(2.562,4.662)、5.845(4.324,7.901)、8.625(6.446,11.539)、13.001(9.401,17.961)、17.389(12.168,24.845).年龄35～≤39岁及≥40的患者累积活产率与≤30岁的患者相比显著下降,OR值分别为0.570(0.455,0.714)、0.243(0.165,0.357). 结论 累积活产率随着获卵数的增多而增高,获卵数是累积活产率的强预测指标.%Objective:To explore the correlation between the number of oocytes retrieved and cumulative live birth rate of IVF/ICSI.Methods:The data of 4 975 cycles undergone the first IVF cycle in our center from April 2014 to June 2015 were retrospectively analyzed.The patients were divided into six groups according to the number of oocytes retrieved:1-3 (Group A);4-6 (Group B);7-9 (Group C);10-15 (Group D);16-20 (Group E);＞20(Group F).The age,etiology of infertility,2PN rates,cumulative live birth rate and all embryos frozen rate for high risk of OHSS were compared among the six groups.The logistic multivariate analysis was done between age,number of oocytes retrieved & ovulation induced protocol and cumulative live birth rate.Results:With the increase of the number of oocytes retrieved,the cumulative live birth rate and all embryos frozen rate for high risk of OHSS were significantly enhanced (P＜0.05).The group F had the lowest rate of embryo transfer in the fresh cycle and the lowest 2PN rate (P＜0.05).The group A had the highest rate of no embryo transferable and the lowest live birth rate in the fresh cycle (P＜0.05).Logistic multivariate analysis showed that the live birth rate was significantly increased from group B to group F compared with group A,and the OR was 3.456 (2.562,4.662),5.845 (4.324,7.901),8.625 (6.446,11.539),13.001(9.401,17.961),17.389(12.168,24.845) respectively.The cumulative live birth rate in 35-39 years and ≥40 years old patients was significantly lower than that in the patients ≤30 years old,and the OR was 0.570(0.455,0.714),and 0.243(0.165,0.357)respectively.Conclusions:The cumulative live birth rate is significantly increased along with the number of oocytes retrieved.The number of oocytes retrieved is a strong independent predictor for cumulative live birth rate.