Clinical and Experimental Reproductive Medicine

  • 제35권3호
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  • Pages.213-221
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  • 2008
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  • 2233-8233(pISSN)
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  • 2233-8241(eISSN)
대한생식의학회 (The Korean Society for Reproductive Medicine)
권호 표지

저반응군의 체외수정에서 한 개의 배아 이식 시 임신에 영향을 주는 요인

Predictor of IVF Outcomes Following Single Embryo Transfer in Poor Responder Patients

  • 김혜옥 (관동대학교 의과대학 제일병원 산부인과 불임 및 생식내분비분과) ;
  • 김민지 (관동대학교 의과대학 제일병원 산부인과 불임 및 생식내분비분과) ;
  • 연명진 (관동대학교 의과대학 제일병원 산부인과 불임 및 생식내분비분과) ;
  • 차선화 (관동대학교 의과대학 제일병원 산부인과 불임 및 생식내분비분과) ;
  • 궁미경 (관동대학교 의과대학 제일병원 산부인과 불임 및 생식내분비분과) ;
  • 송인옥 (관동대학교 의과대학 제일병원 산부인과 불임 및 생식내분비분과)
  • Kim, Hye-Ok (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Kim, Min-Ji (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Yeon, Myeong-Jin (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Cha, Sun-Wha (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Koong, Mi-Kyoung (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Song, In-Ok (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
  • 발행 : 2008.09.30
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초록

목 적: 난소기능이 저하된 저반응군 불임 여성에서 한 개의 배아를 이식할 때 임신율에 영향을 주는 요인에 대해 알아보고자 한다. 연구방법: 본원에서 1996년 6월부터 2006년 4월까지 시험관 시술을 받은 환자 중, basal FSH가 12 mIU/mL 이상, 획득된 난자가 4개 이하, hCG 투여일에 혈청 $E_2$가 500 pg/ml 미만인 저반응군 총 919주기에서 한 개의 배아만을 이식한 235주기를 대상으로 하였다. 여성의 연령, hCG 투여일에 혈청 $E_2$, basal FSH, 3일째 배아 이식 시 할구수, 과배란 유도 방법, 이식 횟수에 따른 임신율과 생존아 출생률을 비교하였으며, 통계학적인 방법은 Chi-square를 이용하여 p-value 0.05 이하인 경우를 유의하게 평가하였다. 결 과: 총 919주기 중 난자채취 취소율은 25.6% (235주기), 난자채취 실패율은 18.5% (170주기), 배아 이식 취소율은 14.0% (129주기)였다. 한 개의 배아를 이식한 군의 전체 임신율은 8.1% (19주기), 생존아 출생률은 4.7% (11주기)였고, 35세 미만의 여성에서 35세 이상의 여성보다 임신율과 생존아 출생률이 통계적으로 유의하게 높았다 (20% vs. 3.5% p<0.0001, 12.3% vs. 1.8%, p=0.002). hCG 투여일에 혈청 $E_2$, basal FSH, 3일째 배아 이식 시 할구수, 과배란 유도 방법에 따른 임신율과 생존아 출생률은 차이가 없었다. 이식 횟수에 따른 누적 임신율은 1회에 8.1%, 2회에 9.2%, 3회에 9.7%, 4회에 9.0%, 5회에 9.5%였다. 결 론: 저반응군의 체외수정에서 한 개의 배아를 이식할 때, 불임 여성의 연령이 35세 미만에서 임신율과 생존아출생률이 유의하게 증가함을 확인하였고, 이식 횟수에 따른 누적 임신율은 차이가 없었다. 이는 체외수정을 시도하려고 하는 난소기능 저하의 불임 여성에서 구체적인 상담 자료로 사용할 수 있겠다.

Objective: To evaluate predictor of IVF outcomes following single embryo transfer in patients with decreased ovarian reserve. Methods: A retrospective review was performed in 919 IVF cycles with elevated basal serum FSH (${\geq}12\;mIU/mL$), the number of retrieved oocytes ${\geq}4$ and serum $E_2$ concentration on hCG day <500 pg/ml between Jan. 1996 and Dec. 2006. Two hundred thirty five IVF cycles following single embryo transfer were included. Pregnancy rates and live birth rates was evaluated according to maternal age, serum $E_2$ on hCG day, basal FSH level, the number of blastomere on day 3 ET, stimulation protocol, the number of cycles of ET. Statistical analysis was used SPSS 12.0 program. Results: OPU cancellation rates were 25.6% (235 cycles), OPU failure rates were 18.5% (170 cycles), embryo transfer cancellation rates were 14.0% (129 cycles). Pregnancy rates following single embryo transfer was 8.1% (19 cycles) and live birth rates was 4.7% (11 cycles). Pregnancy rates and live birth rates of women under 35 years old was statistically higher than those of women above 35 years old (20% vs. 3.5% (p<0.0001), 12.3% vs. 1.8%, (p=0.002)). There was no difference in basal FSH, serum $E_2$ on hCG day, and the number of blastomere on ET, and stimulation protocol. Cumulative pregnancy rates according to the number of cycles of ET were $1^{st}$ 8.1%, $2^{nd}$ 9.2%, $3^{rd}$ 9.7%, $4^{th}$ 9.0%, and $5^{th}$ 9.5%. Conclusion: Pregnancy rates and live birth rates of IVF-ET cycles following single embryo transfer in patients with decreased ovarian reserve are statistically increased in women under 35 yrs old. There is no difference in cumulative pregnancy rates. These data may be helpful for counseling women with decreased ovarian reserve in attempting IVF with their own eggs or when choosing donor oocytes.

키워드

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