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目的探讨重复IVF/ICSI-ET治疗对卵巢反应性影响以及提高重复周期临床妊娠率的方法。方法对本中心97例不孕症患者208个长方案超促排卵IVF/ICSI-ET治疗周期进行回顾性分析。结果与第1次IVF/ICSI-ET治疗相比,第3次治疗组临床妊娠率显著提高(42.9%,P<0.05),但在获卵数、MⅡ卵、胚胎形成以及优质胚胎获得上无明显差异(P>0.05)。其中50例患者接受了宫腔镜检查或子宫内膜清创术后,第2次治疗时,子宫内膜声像清晰者的临床妊娠率明显高于子宫内膜声像仍然欠清晰者(38.5%vs16.7%,P<0.05);经输卵管切除术和造口术后的IVF/ICSI-ET治疗临床妊娠率为54.5%,明显高于输卵管积液穿刺术者20.0%(P<0.05)。结论在3个VF/ICSI-ET治疗周期内,卵巢反应性无明显改变。重复超促排卵治疗的患者应更加关注盆腔情况与子宫容受性的改善,提高临床妊娠率。
Objective To investigate the effect of repeated IVF / ICSI-ET on ovarian response and to improve the clinical pregnancy rate in repetitive cycles. METHODS: A retrospective analysis of 208 long-term ovulation induction (IVF / ICSI-ET) cycles in 97 infertility patients was conducted. Results Compared with the first IVF / ICSI-ET treatment, the clinical pregnancy rate in the third treatment group was significantly increased (42.9%, P <0.05). However, there was no significant difference in the number of oocytes retrieved, M Ⅱ eggs, embryogenesis, Significant difference (P> 0.05). 50 cases of patients underwent hysteroscopy or endometrial debridement, the second treatment, the clinical pregnancy rate was significantly higher in endometrial ultrasonography than in endometrial imaging is still not clear (38.5 % vs16.7%, P <0.05). The clinical pregnancy rate after ovariectomy and IVF / ICSI-ET after ostomy was 54.5%, which was significantly higher than that of tubal puncture (20.0%, P0.05) . Conclusion There was no significant difference in ovarian reactivity during the three VF / ICSI-ET cycles. Patients with repeated superovulation should pay more attention to the improvement of pelvic conditions and uterine receptivity and improve the clinical pregnancy rate.