体外受精治疗多囊卵巢综合症与仅多囊卵巢不孕患者的临床特征和治疗结局分析  

Analysis of the clinical outcomes of IVF-ET treatment in infertile patients with polycystic ovary syndrome or polycystic ovaries

作　　者：王庆玲[1] 宋娟[1] 陈士岭[1] 罗琛[1] 陈薪[1] 李敏[1] 倪运萍[1] 

机构地区：[1]南方医科大学南方医院生殖中心,广州510515

出　　处：《南方医科大学学报》2009年第5期962-965,共4页Journal of Southern Medical University

基　　金：国家重点基础研究发展规划课题(973课题)(2007CB948104);国家自然科学基金(30470657);广东省自然科学基金(04020416)

摘　　要：目的比较体外受精(IVF)治疗的多囊卵巢综合征(PCOS)、仅多囊卵巢(PCO)与正常对照不孕患者的临床特征及治疗结局的差异。方法分析和比较3组患者IVF治疗的促性腺激素用量、HCG日性激素值、临床妊娠率、自然流产率及卵巢过度刺激综合征(OHSS)发生率等。结果202个PCOS患者周期、134个PCO患者周期和150个正常对照患者周期的临床妊娠率分别为51.0%、53.0%和46.0%,无明显差异(P>0.05);PCOS组LH值、T值增加,早期自然流产率明显高于PCO组与对照组(P<0.05);PCO组的HCG日P值较其他两组升高(P<0.05),临床妊娠率、自然流产率与对照组相比无显著性差异(P>0.05);PCOS组与PCO组的促性腺激素用量少、OHSS发生率显著增加(P<0.05)。结论PCOS患者进行IVF治疗能获得与PCO及正常对照患者相同的临床妊娠率,但其早期自然流产率增加,考虑LH、T的分泌异常可能为其原因之一;PCO患者临床结局与正常反应者相近,卵泡晚期P水平升高对IVF治疗结局无明显影响;PCOS患者与仅PCO患者发生OHSS风险增加。Objective To study the clinical features and outcomes of in vitro fertilization and embryo transfer （IVF-ET） in infertile patients due to polycystic ovary syndrome （PCOS） or polycystic ovaries （PCO）. Methods This study involved 189 infertile patients with polycystic ovary syndrome （PCOS）, with 129 polycystic ovaries （PCO）, and 142 without PCOS or PCO （control） undergoing IVF-ET. The dosage of gonadotrophin （Gn）, sex hormone level on the day of HCG administration, clinical pregnancy rate, spontaneous abortion rate and ovarian hyperstimulation syndrome （OHSS） rate were analyzed and compared between the 3 groups. Results No significant differences were found in the clinical pregnancy rate between the PCOS group （202 cycles）, PCO group （134 cycles） and control group （150 cycles） （51.0%, 53.0% and 46.0%, respectively）. The levels of LH and T and early spontaneous abortion rates were significantly higher in PCOS group than in PCO group and control group （P〈0.05）. The P level on HCG day was the highest in PCO group （P〈0.05）. The early spontaneous abortion rates and clinical pregnancy rate showed no significant differences between PCO group and control group （P〉0.05）. The dasage of Gn was significantly lower and OHSS rate higher in PCOS and PCO groups than in the control group （P〈0.05）. Conclusions The clinical pregnancy rate of infertile patients with PCOS is similar with that of PCO patients and control patients undergoing /VF-ET treatment. PCOS, however, is associated with increased spontaneous abortion rate, possibly due to abnormality of LH and T release. The clinical outcomes in PCO patients are similar with those in the control patients, and elevated P level in the late follicular phase does not obviously influence the outcomes of IVF. Both PCOS and PCO are associated with increased risk of OHSS.

关 键 词：体外受精 多囊卵巢综合征 卵巢过度刺激综合征 自然流产 

分 类 号：R711.6[医药卫生—妇产科学]