提早一日到星期五取卵或順延一日到星期一取卵，其臨床結果並無明顯差別
打排卵針時機: 2顆以上卵泡>17mm; 大部分卵泡>14mm‧
http://humrep.oxfordjournals.org/content/25/5/1219.full
Avoidance of weekend oocyte retrievals during GnRH antagonist treatment by simple advancement or delay of hCG administration does not adversely affect IVF live birth outcomes
+Author Affiliations
- *Correspondence address. Fax: +61-8-83338188; E-mail:kelton.tremellen@adelaide.edu.au
- Received November 5, 2009.
- Revision received February 5, 2010.
- Accepted February 12, 2010.
Abstract
BACKGROUND The use of GnRH antagonists in IVF treatment has many advantages over agonist long down-regulation, yet its uptake has been hampered by an inability to program the start date for gonadotrophin stimulation so as to minimize weekend oocyte retrievals (ORs). In this study, we retrospectively analyzed whether conducting a strict Monday to Friday OR program impacts on IVF outcomes.
METHODS A total of 1642 non-programmed IVF antagonist cycles were analyzed to determine if advancing or delaying the OR by 1 day from ‘ideal’ to avoid Saturday or Sunday OR, respectively, had any impact on IVF outcomes. The IVF outcomes of Tuesday to Thursday served as a control as no modification in OR timing was required on these days.
RESULTS Advancing the OR by 1 day from the ideal resulted in a small but significant decrease in the number of oocytes collected and embryos created. Delaying the OR by 1 day from ideal resulted in a small increase in the number of oocytes collected and embryos created. However, deviation from the ideal day of OR had no significant effect on live birth rates.
CONCLUSIONS It is possible to safely avoid weekend ORs during GnRH antagonist cycles by simply advancing an ideal Saturday OR to Friday, and delaying an ideal Sunday OR to Monday, without adversely impacting on IVF live birth outcomes.
Table II
IVF treatment outcomes according to the day of OR.
| Control (Tuesday–Thursday OR) | Monday OR | Friday OR | P-value | |
|---|---|---|---|---|
| Days of rFSH stimulation | 9.47 ± 2.18 | 10.1 ± 2.26 | 8.88 ± 2.07 | <0.0001 |
| Number oocytes collected | 8.82 ± 5.51 | 8.90 ± 5.67 | 8.60 ± 5.63 | 0.6969 |
| Number embryos produced | 5.21 ± 3.80 | 5.32 ± 3.83 | 4.94 ± 3.87 | 0.260 |
| Fertilization rate (%) | 58.66% | 58.85% | 57.40% | 0.131 |
| Number of embryos transferred | 1.20 ± 0.50 | 1.19 ± 0.51 | 1.21 ± 0.51 | 0.906 |
| Number of embryos cryopreserved | 1.15 ± 1.86 | 1.30 ± 1.96 | 1.06 ± 1.95 | 0.143 |
| Biochemical pregnancy rate per OR (%) | 39.84% (318/798) | 38.98% (184/472) | 39.78% (148/372) | 0.950 |
| Implantation rate (%) | 31.03% (296/954) | 30.72% (173/563) | 33.40% (150/449) | 0.603 |
| Live birth rate (%) | 32.83% (262/798) | 31.77% (150/472) | 34.14% (127/372) | 0.525 |
Table III
IVF outcomes for ORs conducted on the ideal day of scheduling compared with those advanced or delayed by 1 day from ideal.
| Monday OR | P-value | Friday OR | P-value | |||
|---|---|---|---|---|---|---|
| Ideal Monday OR (n= 221) | Ideal Sunday OR (n = 251) | Ideal Friday OR (n= 207) | Ideal Saturday OR (n= 165) | |||
| Number of days rFSH stimulation | 9.66 ± 2.5 | 10.48 ± 1.9 | <0.0001 | 9.30 ± 2.1 | 8.35 ± 1.9 | <0.0001 |
| Number of oocytes | 7.78 ± 5.5 | 9.88 ± 5.6 | <0.0001 | 9.04 ± 5.7 | 7.95 ± 5.4 | 0.0241 |
| Number of embryos | 4.78 ± 3.6 | 5.78 ± 3.9 | <0.004 | 5.32 ± 4.1 | 4.45 ± 3.5 | 0.010 |
| Fertilization rate (%) | 60.0% | 58.0% | 0.187 | 58.01% | 55.0% | 0.093 |
| Embryos transferred | 1.15 ± 0.50 | 1.23 ± 0.51 | 0.128 | 1.27 ± 0.5 | 1.13 ± 0.5 | 0.006 |
| Embryos cryopreserved | 1.07 ± 1.7 | 1.51 ± 2.1 | 0.675 | 1.19 ± 2.1 | 0.91 ± 1.7 | 0.142 |
| Biochemical pregnancy rate (%) | 38.91% (86/221) | 39.04% (98/251) | 0.977 | 40.0% (83/207) | 35.8% (59/165) | 0.391 |
| Implantation rate (%) | 32.15% (82/255) | 29.54% (91/308) | 0.503 | 34.60% (91/263) | 31.72% (59/186) | 0.523 |
| Live birth rate (%) | 30.76% (68/221) | 33.06% (83/251) | 0.621 | 35.74% (74/207) | 32.12% (53/165) | 0.463 |
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