肖宇　王旻　王勇

[摘要] 目的 研究体外受精-胚胎移植（IVF-ET）治疗是否受到四季变化的影响。 方法 回顾2010年1月～2016年12月6年来在国际和平妇幼保健院辅助生殖科因输卵管因素或少弱精子因素接受IVF-ET治疗的4504个周期，根据ET日期按四季分布划分为4组：春季组1172例，夏季组1356例，秋季组1115例，冬季组861例。所有患者均采用长方案或拮抗剂方案。比较4组患者的卵巢反应、卵母细胞-胚胎情况及妊娠结局。 结果 各组间促性腺激素（Gn）用量、Gn时长比较，差异无统计学意义（P > 0.05）。秋季的成熟卵数、受精数、受精率、卵裂数、有效胚胎数等均显著高于其他3个季节（P < 0.05），而冬季的有效胚胎率则明显偏低（P < 0.01）。4个季节的获卵数、成熟卵率均在同一水平（P > 0.05）。各季节组间的胚胎种植率、临床妊娠率、活产率、自然流产率等差异无统计学意义（P > 0.05）。 结论 IVF-ET治疗中，四季变化可能对受精、胚胎发育等方面造成影响，但这种影响不足以带来妊娠结局的明显改变。一年中任意季节接受IVF-ET治疗均是可行的。

[关键词] 季节；体外受精；气温；促排卵；妊娠率

[中图分类号] R711.6 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0120-04

[Abstract] Objective To investigate the influences of seasonal variability on in vitro fertilization （IVF） and embryo transfer （ET）. Methods The data of 4505 IVF cycles in 6 years （from January 2010 to December 2016） treated for tube factor， oligospermatism and/or asthenospermia in Reproductive Medical Center， the International Peace Maternity and Child Health Hospital were collected retrospectively. According to the day of ET， these cycles were divided into four season groups （1172 cycles in Spring， 1356 in Summer， 1115 in Autumn， and 861 in Winter）. All cycles were administered with the GnRH analog formula. Response of ovarian， embryo quality， and reproductive outcomes were compared among groups. Results The total dose and duration of gonadotropin were similar in each group （P > 0.05）. The matured oocytes and fertilization number， fertilization rates， cleavage and valid embryo numbers were significantly higher in Autumn （P < 0.05）， whereas the valid embryos were fewer in Winter （P < 0.05）. Total oocyte numbers and maturation rates in each season group were comparable （P > 0.05）. The implantation rate， clinical pregnancy rate， live birth rate and miscarriage rate among four seasons had no significant differences （P > 0.05）. Conclusion Seasonality may have influences on fertilization and embryo development， which are insufficient to change the pregnancy outcomes of IVF-ET treatment. It is feasible that IVF-ET treatment could be provided in any season.

[Key words] Season； In vitro fertilization； Weather； Ovarian stimulation； Pregnancy rate

季節变化在哺乳动物受孕进程中所起作用的研究由来已久。针对人类的研究也发现自然妊娠受到季节变化的影响，多胎妊娠、宫外孕、自然流产、死产、活产等均被认为可能会受到季节变化的影响[1]。男性精液质量被认为与温度变化有关[2]，而女性的排卵节律被认为与光照强度有关[3]，这些均是季节变化造成人类生育力变化的可能途径。体外受精（IVF）是人类通过辅助生育技术获得妊娠的一种治疗方式，区别于自然妊娠，在多个方面均受到人为干预。季节……