打孔术对多囊卵巢综合征体外受精助孕的影响  

Effect of ovarian drilling on in vitro fertilization and proconception of infertile women with PCOS

作　　者：李海仙[1] 马文敏[1] 

机构地区：[1]佛山市妇幼保健院生殖中心,广东佛山528000

出　　处：《中国妇幼健康研究》2009年第2期185-186,共2页Chinese Journal of Woman and Child Health Research

基　　金：[基金项目]佛山市科技攻关资助项目（200808002）

摘　　要：目的探讨腹腔镜下卵巢打孔术对接受体外受精-胚胎移植助孕的多囊卵巢综合征患者治疗效果的影响。方法对2004年1月至2008年5月在佛山市妇幼保健院生殖中心行体外受精-胚胎移植或卵胞浆内单精子显微注射助孕的多囊卵巢综合征患者作回顾性分析，研究组为辅助助孕前曾行腹腔镜下卵巢打孔术，共45例；对照组为助孕前未行卵巢打孔术，共51例，比较两组促性腺激素用量、使用天数、获卵数、妊娠率、流产率及卵巢过度刺激综合征发生率。结果研究组使用促性腺激素总量和天数分别为34．4±6．3支和15．7±5．3天，较对照组（21．2±7．0支和11．4±4．6天）明显增加，两组比较有显著性差异（t分别为9．447、6．169，均P〈0．01）；研究组平均获卵数为8．5±2．2个，妊娠率为40．0％，较对照组（16．2±6．7个、52．9％）低，两组比较有显著性差异（获卵数t=-7．527，P〈0．01；妊娠率X2=4．123，P〈0．05）。两组卵巢过度刺激综合征发生率和流产率无明显差异（P〉0．05）。结论对于需进行体外受精-胚胎移植或卵胞浆内单精子显微注射助孕的多囊卵巢综合征患者术前进行腹腔镜下卵巢打孔术，可影响超促排卵中卵巢反应性，增加促性腺激素用量的同时降低获卵数和妊娠率。Objective To investigate therapeutic effect of laparoscopic ovarian drilling for women with polycystic ovary syndrome （PCOS） who received proconception by in vitro fertilization embryo transfer （IVF-ET）. Methods The clinical data of 96 patients with PCOS who received IVF-ET or intracytoplasmic single sperm microinjection （ICSI） for proconception over a period from January, 2004 to May, 2008 in the Center of Reproduction of Foshan Municipal Maternal and Child Health Hospital were analyzed retrospectively. The patients in the study group underwent laparoscopic ovarian drilling （ n = 45 ） before assissted proconception and those in the control group didn＇ t underwent laparoscopic ovarian drilling（ n = 51 ）. The dosage and duration of gonadotropin, number of retrieved oocyte, pregnancy rate, abortion rate and incidence of ovarian hyperstimulation syndrome （OHSS） were compared between the two groups. Results The total dosage and administration days of gonadotropin in the study group were 34.4± 6.3 amples and 15.7 ± 5.3 days and those in the control group were 21.2 ± 7.0 amples and 11.4 ± 4.6 days, there were significant differences between the two groups （ t = 9. 447 and 6. 169 respectively, both P 〈 0.01 ）. In the study group, the number of retrieved oocyte was 8.5 ± 2.2 and the pregnancy rate was 40.0% , and those in the control group were 16.2 ±6.7 and 52.9%, there were significant differences between the two groups （for the number of retrieved oocyte： t = -7. 527 ,P 〈 0.01; for pregnancy rate： X2 = 4. 123, P 〈 0.05 ）. In incidence rates of OHSS and abortion there were no significant differences between the two groups（ both P 〉0.05）. Conclusion Laparoscopic ovarian drilling before proconception for those women with PCOS who expect to receive IVT-ET or ICSI can effect ovarian response in stimulated over-ovulation, resulting in decresed number of retrieved oocyte and decreased pregnancy rate.

关 键 词：卵巢打孔 多囊卵巢综合征 体外受精-胚胎移植 卵巢反应性 

分 类 号：R711.75[医药卫生—妇产科学]