未成熟卵母细胞体外成熟培养治疗多囊卵巢综合征不孕患者的妊娠结局  

Outcome of pregnancy in women with polycystic ovary syndrome treated by in vitro maturation of immature oocytes

作　　者：赵军招[1] 陈霞[1] 王佩玉[1] 周玮[1] 林金菊[1] 张巍[1] 黄学锋[1] 林文琴[1] 杨海燕[1] 陈雅[1] 

机构地区：[1]温州医学院附属第一医院生殖医学中心,325000

出　　处：《中华妇产科杂志》2009年第6期409-412,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨多囊卵巢综合征不孕患者行未成熟卵母细胞体外成熟（IVM）培养后妊娠的结局。方法2003年11月至2007年10月，观察温州医学院附属第一医院生殖医学中心118例多囊卵巢综合征不孕患者接受未成熟卵母细胞IVM培养的140个周期，获得妊娠62例，采用定期来院复诊及电话询问等方式进行随访，监测其妊娠状况直至分娩，记录其妊娠结局及围产期情况。结果62例中，生化妊娠5例，临床妊娠57例，临床妊娠率为40．7％（57／140）。57例临床妊娠中，2例异位妊娠，占3．5％（2／57）；35例单胎妊娠，占61．4％（35／57），其中7例分别于孕7～14周流产，早期流产率占12．3％（7／57）；双胎妊娠17例，占29．8％（17／57），1例于孕8周双胎之一心脏搏动消失，另一例于孕22周因胎膜早破流产；三胎妊娠3例，占5．3％（3／57）。妊娠并发症总的发生率为26．3％（15／57），包括胎膜早破（1例）、前置胎盘（1例）、妊娠期糖尿病（2例）、妊娠期高血压疾病（1例）以及早产（10例）。分娩47例，包括双胎18例（其中3例为三胎妊娠减胎后），单胎29例，共65个新生儿，其巾1例早产女婴在出生后第6天因新生儿肺炎死亡，其余至今未发现明显畸形。10例早产，占21．3％（10／47），36例足月产，占76．6％（36／47），1例过期妊娠。新生儿平均出生体重2972g，低体重儿17例，占26．2％（17／65）。结论多囊卵巢综合征不孕患者行未成熟卵母细胞IVM培养后，虽然获得了较高的临床妊娠率，而且早期流产率、异位妊娠率、妊娠并发症发生率、围产儿死亡及新生儿缺陷的发生率等不高，但多胎妊娠、早产、低出生体重儿发生率较高。Objective To investigate pregnancy outcome of infertility women with polycystic ovary syndrome（PCOS） treated by in vitro maturation （IVM） of immature oocytes. Methods From Nov. 2003 to Oct. 2007, medical documents of 118 women with PCOS underwent 140 IVM treatment cycles in Reproductive Medical Center of First Affiliated Hospital of Wenzhou Medical College were collected. Follow up of 62 pregnancies were performed by prenatal examination in hospital or telephone query to record perinatal monitoring and pregnancy outcome. Results There are 62 pregnant women including 5 biochemical pregnancies and 57 clinical pregnancies obtained in 140 transferred cycles, resulting in the pregnancy rate of 40. 7% （57/140）. The rates of singleton pregnancies, twin pregnancies and triplet pregnancies were 61.4% （35/57） , 29. 8% （17/57） and 5.3% （3/57） , respectively. The rate of ectopie pregnancy was 3.5% （2/57）. Seven （7/57, 12. 3% ） women underwent early abortion during 7 -14 weeks of pregnancy, and 1 ease （ 1/57, 1.75% ） with premature rupture of membranes occurred at 22 gestational week. One woman with twin pregnancy spontaneously reduced to singleton at 8 gestational weeks. Totally, the rate of pregnancy complications was 26. 3% （15/57） including premature rupture of membranes （1 case）, placenta previa （1 case）, hypertensive disorder （1 case）, preterm delivery （l0 cases） and gestational diabetes mellitus （2 cases）. Until now 47 women gave birth to 65 infants including 29 singleton infants and 18 twins. One female preterm neonate died after 6 days＇ delivery due to pneumonia, no malformation was observed on the other neonates. 21.3% （10/47） of deliveries were premature,76. 6% （36/47） of deliveries were full-term, 2. 1% （ 1/47 ） of deliveries were postterm. The mean birth weight was 2972 gram. The rate of infants with low weight was 26. 2% （ 17/65 ）. Conclusions A relatively high clinical pregnancy rate has been achieved, the rates of early abortion, ect

关 键 词：多囊卵巢综合征 不育 女(雌)性 卵母细胞移植 妊娠结局 随访研究 

分 类 号：R686[医药卫生—骨科学]