Demographic characteristics and clinical profile of poor responders in IVF / ICSI: A comparative study.
Demographic characteristics and clinical profile of poor responders in IVF / ICSI: A comparative study.
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DOI：
10.4103/0974-1208.69343
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发表时间：
2010-05
影响因子：
--
通讯作者：
Varma T
中科院分区：
文献类型：
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作者：
Padhy N;Gupta S;Mahla A;Latha M;Varma T
卵巢反应在个体之间差异很大，取决于各种因素。IVF反应差产生的卵母细胞较少，与妊娠前景较差相关。由于反应不良而导致的循环取消令临床医生和患者都感到沮丧。研究表明，与卵巢反应正常的妇女相比，卵巢反应不良的妇女怀孕时有更多的妊娠并发症，如妊高征和先兆子痫。此外，卵巢反应不良可能是绝经早期的预测因素。本文研究了各种人口统计学和临床资料的不良反应，并试图看看已知和未知的因素，可能会导致卵巢反应不良的体外受精。回顾性收集了104名在检索时少于4个卵母细胞的不良反应者的数据，并与324名良好反应者进行了年龄，BMI，生育力低下类型，生育力低下持续时间，环境因素如工作压力，吸烟，盆腔手术，慢性疾病，IVF适应症，基础FSH，母亲平均绝经年龄等因素的比较。年龄在35岁以上者占60.57%，对照组为36.41%，有统计学意义。在反应差的组中，母亲的平均绝经年龄提前了4年。男性因素和不明原因不孕在反应良好者中显著高于反应良好者（P <0.05）。研究组中有31.73%的妇女曾接受过盆腔手术（P<0.05）。除年龄外，既往盆腔手术史也可作为卵巢反应不良的预测因素。遗传也在决定卵巢反应中起主要作用。
Ovarian response varies considerably among individuals and depends on various factors. Poor response in IVF yields lesser oocytes and is associated with poorer pregnancy perspective. Cycle cancellation due to poor response is frustrating for both clinician and the patient. Studies have shown that women conceiving after poor ovarian response have more pregnancy complications like PIH and preeclampsia than women with normal ovarian response. In addition, poor ovarian response could be a predictor of early menopause. This paper studies various demographic and clinical profiles of poor responders and tries to look at the known and unknown factors which could contribute to poor ovarian response in IVF. Data were collected retrospectively from 104 poor responders who had less than four oocytes at retrieval and compared with 324 good responders for factors like age, BMI, type of sub fertility, duration of sub fertility, environmental factors like stress at work, smoking, pelvic surgery, chronic medical disorder, indication of IVF, basal FSH, mean age of menopause in their mothers etc. Among the poor responders, 60.57% were above 35 years of age compared to 36.41% in control group, which is statistically significant. Mean age of menopause in mother was found to be four years earlier in poor responder group. Male factor and unexplained infertility were significantly (P<0.05) higher in good responders (P<0.05). Significant proportion (31.73%) of women in study group had undergone some pelvic surgery (P<0.05). Apart from age, prior pelvic surgery also could be used as predictors for poor ovarian response. Heredity also plays a major role in determining ovarian response.