二甲双胍对多囊卵巢综合征患者体外受精-胚胎移植影响的初步研究  

The role of metformin in IVF-ET treatment in women with PCOS

作　　者：肖宇[1] 程静[1] 黄永刚[1] 吕杰强[1] 

机构地区：[1]浙江温州医学院附属第二医院生殖医学中心,温州325000

出　　处：《海峡药学》2011年第12期106-110,共5页Strait Pharmaceutical Journal

摘　　要：目的探讨二甲双胍预处理对多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)的影响。方法随机将60名PCOS患者分为二甲双胍组和对照组,接受3个月预处理,然后开始IVF-ET治疗。对比分析两组患者的一般情况、代谢水平、超排卵过程、胚胎情况及妊娠结局。结果两组人群在预处理前后的代谢水平、胰岛素敏感性变化无显著差异(P>0.05)。二甲双胍组的Gn使用剂量及天数、HCG日E2水平、内膜厚度均与对照组相似(P>0.05);而获卵数(8.90±8.94)、成熟卵数(8.20±8.43)、受精胚胎数(6.80±6.22)均显著小于对照组(14.92±5.25,14.08±5.40,13.67±5.26,P<0.05)。二甲双胍组的优质胚胎率稍高于对照组(44.12%比32.32%),但差异不明显(P>0.05)。两组间临床妊娠率无显著差异(P>0.05),二甲双胍组早期流产率稍低(20%比50%),但差异不显著(P>0.05)。结论 PCOS患者在开始IVF-ET治疗前服用3个月的二甲双胍并不能有效改善超排卵情况和妊娠结局,但可能对防止流产有一定作用。OBJECTIVE To investigate the effect of metformin treatment in women with PCOS undergoing IVF-ET.METHODS A randomized controlled study was carried out and 60 women with PCOS undergoing IVF-ET treatment were randomized to receive metformin,or just have lifestyle adjusted,for three months before IVF started.The main outcome measures were doses of Gn,duration of stimulation,total number of oocytes,mature oocytes,embryos,clinical pregnancy rates,and early abortion rates.RESULTS No differences were found between two groups in sex hormone level or insulin sensitivity before or after the pre-treatment.Metformin treatment did not affect the Gn dose and duration of stimulation.However,total number of oocytes,mature oocytes and embryos decreased（8.90±8.94 versus 14.92±5.25,8.20±8.43 versus 14.08±5.40,6.80±6.22 versus 13.67±5.26,P0.05）.The high-quality embryo rate was 44.12% in metformin group,which was slightly higher than 32.32% in control group but not significantly（P0.05）.No differences were found in clinical pregnancy rates,while early abortion rate in metformin group slightly decreased（20% vs.50%,P0.05）.CONCLUSION For patients with PCOS,pre-treatment with metformin for three months might not facilitate the IVF stimulation or improve the pregnancy rate,however,the miscarriage rate might be reduced.

关 键 词：二甲双胍 多囊卵巢综合征 体外受精 

分 类 号：R969.4[医药卫生—药理学]