多囊卵巢综合征患者反复种植失败后成功妊娠3例及其文献复习  

Successful pregnancy following repeated implantation failure in patients with polycystic ovary syndrome: report of three cases

作　　者：易思思[1] 陈薪[1] 刘玉东[1] 叶德盛[1] 陈士岭[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖中心,广东广州510515

出　　处：《南方医科大学学报》2014年第9期1329-1333,共5页Journal of Southern Medical University

基　　金：国家自然科学基金(81170574);国家重点基础研究发展规划课题(973课题)(2007CB948104);广东省中国科学院全面战略合作项目(20100908);广州市科技计划项目重点项目(11C22120737)~~

摘　　要：目的探讨体外受精胚胎移植中多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者反复种植失败(38个移植周期)后获得妊娠分娩的因素,以期对临床提供诊疗参考。方法报告3例多囊卵巢综合症性不孕的患者,在我中心进行多次胚胎移植的临床处理及结局。对这3个病例的临床资料、特点及处理进行分析总结。结果 3例患者经过多次促性腺激素释放激素拮抗剂(GnRH-ant)方案促排卵及促性腺激素释放激素激动剂(GnRHa)诱发排卵,胚胎移植周期9次获得妊娠和分娩。结论对于卵巢高反应的反复种植失败的多囊卵巢综合征患者,采用促性腺激素释放激素激动剂(GnRHa)拮抗剂方案促排卵及GnRHa诱发排卵的方案,寻找和治疗影响胚胎着床的因素,能有效预防卵巢过度刺激征(OHSS)的出现,并取得良好的临床结局。We report 3 cases of polycystic ovary syndrome （PCOS） in which the patients had successful pregnancy after repeated implantation failure in at least 8 in vitro fertilization and embryo transfer （IVF-ET） cycles. The patients were treated with gonadotropin-releasing hormone antagonist （GnRH-ant） protocol and gonadotropin-releasing hormone angonist （GnRHa） for triggering ovulation, and successful pregnancy and normal deliveries were achieved after 9 IVT-ET cycles. For young patients with PCOS but a good ovarian reserve and a high ovarian response, treatment with GnRH antagonist protocol and GnRHa alone with appropriate management of the factors that may affect implantation can prevent severe ovarian hyperstimulation syndrome to achieve favorable clinical outcomes.

关 键 词：体外受精胚胎移植(IVF-ET) 多囊卵巢综合征 反复种植失败 卵巢过度刺激征 

分 类 号：R711.75[医药卫生—妇产科学] R714.8[医药卫生—临床医学]