【摘要】 目的分析卵母细胞透明带发育不良的相关因素。方法回顾性分析2015年10月至2016年7月于北京大学深圳医院生殖医学科行IVF治疗的患者共569个周期的临床资料,按是否出现透明带发育不良分为2组:出现卵母细胞透明带发育不良为A组,217个周期;卵母细胞正常为B组,352个周期。比较两组基本资料。再按年龄和卵巢功能分组来比较促排卵、获卵与受精情况,分析临床结局。结果 A组与B组相比,年龄[(35.4±5.6)岁vs.(34.4±5.9)岁]、基础FSH[(9.37±5.37)U/L vs.(8.52±4.00)U/L]、AMH[(3.76±5.71)ng/ml vs.(4.68±4.12)ng/ml]均有统计学差异(P<0.05),其中年龄是透明带发育不良的暴露风险因素[OR1.036,95%CI(1.004-1.070)](P<0.05)。再按年龄及卵巢储备功能分组后,≥35~<40岁卵巢储备良好组中的A组与B组相比,Gn天数[(11.7±2.8)d vs.(10.3±3.4)d]、Gn用量[(44.76±16.90)U vs.(34.22±17.44)U]、MII卵数[(6.0±4.1)vs.(9.0±6.1)]均有统计学差异(P<0.05);≥40岁卵巢储备良好组中的A组与B组相比,Gn天数[(11.4±3.9)d vs.(9.4±3.4)d]、Gn用量[(49.24±27.51)U vs.(33.96±18.08)U]、MII卵数[(3.9±2.3)vs.(5.6±4.7)]及优质胚胎率(19.2%vs.40.9%)均有统计学差异(P<0.05)。结论年龄是影响卵母细胞透明带发育的独立暴露危险因素,随着年龄增大(≥35岁时),当患者卵巢储备良好时,Gn用量越多、时间越长,越容易引起透明带发育不良;且透明带发育不良的出现导致该组成熟卵数显著下降,影响促排卵效率;而当年龄≥40岁卵巢储备良好时,透明带发育不良组还会出现优质胚胎率下降。更多还原

【Abstract】 Objective: To determine the related influence factors on zona pellucida dysplasia.Methods: The data of 569 IVF cycles in Beijing University Shenzhen Hospital from Oct 2015 to July2016 were retrospectively analyzed.The cycles were divided into two groups according to whether the occurrence of zona pellucida dysplasia:group A with zona pellucida dysplasia(n=217)and group B without zona pellucida dysplasia(n=352).The basic information were compared between the groups,and then the patients were subdivided by age and ovarian function to compare ovulation,oocytes retrieved,fertilization and clinical outcome.Results:The age[(35.4±5.6)vs.(34.4±5.9)years],basic FSH level[(9.37±5.37)vs.(8.52±4.00)U/L],and AMH level[(3.76±5.71)vs.(4.68±4.12)ng/ml]were significantly different between group A and group B(P<0.05).The age was a exposure risk factor for zona pellucida dysplasia[OR1.036,95%CI(1.004-1.070)](P<0.05).After grouped by age and ovarian reserve,in patients with normal ovarian reserve and aged≥35 to<40 years,the duration of gonadotropin(Gn)used[(11.7±2.8)vs.(10.3±3.4)days],Gn dosage[(44.76±16.90)vs.(34.22±17.44)U/L],number of MII oocytes[(6.0±4.1)vs.(9.0±6.1)]were significantly different between group A and group B(P<0.05).In patients with normal ovarian reserve and aged≥40years,the duration of Gn used[(11.4±3.9)vs.(9.4±3.4)days],Gn dosage used[(49.24±27.51)vs.(33.96±18.08)U/L],MII oocytes[(3.9±2.3)vs.(5.6±4.7)],and high quality embryo rate(19.2%vs.40.9%)were significantly different between group A and group B(P<0.05).Conclusions:Age is an independent risk factor of zona pellucida dysplasia.In patients with normal ovarian reserve,more amount and longer time of Gn used,the more likely to cause zona pellus dysplasia along with age(≥35years old).In addition,the occurrence of zona pellucida dysplasia leads to a significant decline in the number of mature oocytes,affecting the efficiency of ovulation induction.And the high quality embryo rate is significantly lower in zona pellucida dysplasia group in the patients with normal ovarian reserve and≥40years old.更多还原