不同类型多囊卵巢综合征患者行体外受精-胚胎移植的妊娠结局分析  

Analysis of Different Subtypes of Polycystic Ovary Syndrome and Pregnancy Outcome after In-Vitro Fertilization and Embryo Transfer

作　　者：罗璐[1] 刘娟[1] 李洁明[1] 郑清泉[1] Sunita Bhandari 王琼[1] 

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《实用妇产科杂志》2010年第10期787-790,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:对不同类型多囊卵巢综合征(PCOS)患者行体外受精-胚胎移植(IVF-ET)的妊娠结局进行分析,以了解其相互关系,并对PCOS不孕患者进行IVF-ET前的治疗提供参考和依据。方法:对2000年1月至2009年2月在中山大学附属第一医院生殖医学中心进行首个IVF-ET周期的无排卵或稀发排卵PCOS患者共576例进行回顾性分析。按患者进入周期前的临床特征分为4个组别。高雄激素组(高T组):高T的临床和(或)生化表现+双侧卵巢PCO样+稀发或无排卵,共85例;高黄体生成激素组(高LH组):LH/FSH>2+双侧卵巢PCO样+稀发或无排卵,共105例;高T+高LH组:高T的临床和(或)生化表现+LH/FSH>2+双侧卵巢PCO样+稀发或无排卵,共70例;对照组:仅符合双侧卵巢PCO样+稀发或无排卵,共316例。对4组患者的基本资料、IVF-ET周期的卵子和胚胎情况及妊娠结局进行回顾性比较。结果:4组患者的年龄、体重指数、不孕年限比较,差异无统计学意义(P>0.05);IVF周期中的获卵数、受精率、卵裂胚胎数和种植率比较,差异也无统计学意义(P>0.05);临床妊娠率对照组高于其他3组(P<0.05);早期流产率在4组中比较,差异无统计学意义(P>0.05);继续妊娠率对照组高于高T组和高T+高LH组(P<0.05),而高LH组与其他各组比较,差异无统计学意义(P>0.05)。结论:在接受IVF-ET的不同类型无排卵或稀发排卵的PCOS患者中,不合并高T和(或)高LH的患者妊娠结局最佳,高LH血症和高T均对妊娠结局产生不利影响。对PCOS不孕患者行IVF-ET前内分泌紊乱的正确评估及积极纠正可能有利于改善其妊娠结局。Objective：To investigate the pregnancy outcome of different subtypes of polycystic ovarian syndrome （PCOS） after in vitro fertilization and embryo transfer （IVF-ET）,and to provide basis for treatment of PCOS with infertility before IVF-ET.Methods：A total of 576 infertile patients with PCOS undergoing IVF-ET in our center from Jan 2000 to Feb 2009 were retrospectively reviewed in this study and were divided into4 subgroups according to clinical feature before IVF-ET.Group 1 included 85 patients with hyperandrogenism,PCO-like ultrasonography and oligo-ovulation/anovulation.Group 2 included 105 patients with LH/FSH2,PCO-like ultrasonography and oligo-ovulation/anovulation.Group 3 included 70 patients with LH/FSH2 and hyperandrogenism,PCO-like ultrasonography and oligo-ovulation/anovulation.Group 4 included 316 patients with PCO-like ultrasonography and oligo-ovulation/anovulation.The basal information,the condition of oocytes and embryos during IVF-ET cycles,and the pregnancy outcome of the four groups were compared.Results：There was no significant difference about age,body mass index,and duration of infertility among 4 groups（P0.05）.The number of oocytes retrieved,fertilization rate,cleavage numbers and implantation rate were no statistically different among the four groups（P0.05）.Clinical pregnancy rate was significantly higher in group 4 than that in the other 3 groups（P0.05）.Early miscarriage rates were similar in different groups（P0.05）.Subsequent pregnancy rate was higher in group 4 than that in group1 and 3（P0.05）.However,there was no statistical difference between group 2 and other three groups（P0.05）.Conclusions：It has good pregnancy outcomes in different subtype PCOS patients without hyperandrogenism and/or increased LH when receiving IVF-ET.Increased level of LH and hyperandrogenism negatively affects pregnancy outcome.It may ameliorate the pregnancy outcome if we properly evaluate the endocrine disturbance and give pretreatment before IVF cycles in infertile PCOS p

关 键 词：多囊卵巢综合征 体外受精-胚胎移植 妊娠结局 雄激素 黄体生成素 

分 类 号：R711.75[医药卫生—妇产科学]