多囊卵巢综合征患者拮抗剂方案前口服短效避孕药预处理对取卵周期累积妊娠的影响  

Effect of oral contraceptives pretreatment on cumulative clinical pregnancy of oocyte retrieval cycle in polycystic ovary syndrome women with gonadotropin releasing hormone antagonist protocol

作　　者：刘雨奇 薛晴[1] 杨秀丽[1] 徐阳[1] 尚䴖 Liu Yuqi;Xue Qing;Yang Xiuli;Xu Yang;Shang Jing(Reproductive Medical Center of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中华医学杂志》2023年第22期1700-1706,共7页National Medical Journal of China

基　　金：国家自然科学基金(91949113)

摘　　要：目的探讨拮抗剂方案前口服短效避孕药(OC)预处理对多囊卵巢综合征(PCOS)患者取卵周期累积妊娠的影响。方法回顾性分析2017年1月至2020年12月于北京大学第一医院生殖中心采取拮抗剂方案接受体外受精-胚胎移植(IVF-ET)/单精子卵胞浆内注射(ICSI)治疗的PCOS患者的临床资料。共计225例患者,按启动拮抗剂方案前是否接受OC分为OC预处理组(119例)和非预处理组(106例),比较2组患者的基线资料、治疗经过及妊娠结局。采用多因素logistic回归模型分析OC预处理对患者取卵周期累积妊娠的影响。结果225例患者的年龄为(31.1±3.3)岁,OC预处理组和非预处理组患者的年龄分别为(31.0±3.3)和(31.2±3.3)岁(P>0.05),OC预处理组的取卵周期累积妊娠率高于非预处理组(79.8%,95例;67.0%,71例;P=0.029)。年龄<35岁(OR=3.199,95%CI:1.200~8.531,P=0.020)、OC预处理(OR=3.129,95%CI:1.305~7.506,P=0.011)、获卵数(OR=1.102,95%CI:1.007~1.206,P=0.035)及优质胚胎数(OR=1.536,95%CI:1.205~1.957,P=0.001)是取卵周期累积妊娠的相关因素。结论PCOS患者在IVF-ET拮抗剂方案前OC预处理可提高取卵周期累积妊娠率;年龄<35岁、OC预处理、获卵数及优质胚胎数是取卵周期累积妊娠的保护因素。Objective To investigate the effect of pretreatment with oral contraceptives(OC)on cumulative clinical pregnancy of oocyte retrieval cycle in polycystic ovary syndrome(PCOS)women with gonadotropin releasing hormone(GnRH)antagonist protocol.Methods A retrospective cohort study was conducted to analyze PCOS women who underwent in vitro fertilization-embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI)treatment with GnRH antagonist in the Reproductive Medical Center of Peking University First Hospital from January 2017 to December 2020.A total of 225 patients were divided into OC pretreatment group(119 patients)and non-pretreatment group(106 patients),according to whether they received OC before GnRH antagonist protocol.The baseline information,IVF,and pregnancy outcomes of the two groups were compared.A multivariate logistic regression model was used to analyze the effect of OC pretreatment on cumulative clinical pregnancy of the oocyte retrieval cycle.Results The age of 225 patients was(31.1±3.3)years old.The ages of patients in the OC pretreatment group and non-pretreatment group were(31.0±3.3)and(31.2±3.3)years old(P>0.05),respectively.The cumulative clinical pregnancy rate of oocyte retrieval cycle was significantly higher in the OC pretreatment group than that in the non-pretreatment group(79.8%,95 patients;67.0%,71 patients;P=0.029).Age<35 years old(OR=3.199,95%CI:1.200-8.531,P=0.020),OC pretreatment(OR=3.129,95%CI:1.305-7.506,P=0.011),number of oocytes retrieved(OR=1.102,95%CI:1.007-1.206,P=0.035)and number of high-quality embryos(OR=1.536,95%CI:1.205-1.957,P=0.001)were related factors for the cumulative clinical pregnancy of oocyte retrieval cycle.Conclusions OC pretreatment before GnRH antagonist protocol can significantly increase the cumulative clinical pregnancy rate of oocyte retrieval cycle in women with PCOS.Age<35 years old,OC pretreatment,the number of oocytes retrieved,and the number of high-quality embryos were related factors for the cumulative clinical pregnancy of oocyte retrieval

关 键 词：多囊卵巢综合征 避孕药 口服 拮抗剂 预处理 体外受精-胚胎移植 单精子卵胞浆内注射 

分 类 号：R711.75[医药卫生—妇产科学]