克罗米芬抵抗的PCOS不孕患者的IVF治疗疗效分析  

Outcomes of in vitro fertilization-embryo transfers in polycystic ovary syndrome patients with clomiphene citrate resistant

作　　者：陈惠娟[1] 夏舟岚[1] 陆月红[1] 马英英[1] CHEN Hui-juan;XIA Zhou-Ian;LU Yue-hong;MA Ying-ying(Health Care Center for Reproductive Medicine of Shaoxing Women and Children's Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市妇幼保健院生殖中心

出　　处：《中国优生与遗传杂志》2019年第8期1002-1004,共3页Chinese Journal of Birth Health & Heredity

基　　金：浙江省科技厅公共卫生项目(No.2016C33222);绍兴市卫生局项目:2018C30038

摘　　要：目的探讨克罗米芬(CC)抵抗的多囊卵巢综合征(PCOS)不孕患者行体外受精-胚胎移植(IVF-ET)的临床结局。方法回顾性分析2014年1月~2017年12月在绍兴市妇幼保健院生殖中心接受IVF-ET治疗的PCOS患者126例的临床资料,根据实施IVF-ET前CC促排卵的情况分为2组:CC抵抗组37例;CC反应组89例。比较两组患者的一般资料、体重指数(BMI)、基础FSH、LH、E2、T,空腹血糖(FPG)、空腹胰岛素(FINS)、HOMA-IR、促排卵情况、临床妊娠率、流产率等进行分析。结果 CC抵抗组体重、BMI均大于CC反应组,差异有统计学意义(P<0.05);CC抵抗组HOMA-IR高于CC反应组,差异有显著性(P<0.01);CC抵抗组促性腺激素(Gn)量、Gn天数均大于CC反应组,差异有显著性(P<0.05);两组的获卵数、正常受精率、优质胚胎率、移植胚胎数、卵巢过度刺激综合征(OHSS)的发生率及因OHSS取消鲜胚移植率均无差异(P>0.05);但CC抵抗组的妊娠率小于CC反应组,差异有显著性(P<0.05);且CC抵抗组的流产率大于CC反应组,差异有显著性(P<0.05)。结论 CC抵抗的PCOS患者较CC有反应的PCOS患者行IVF-ET助孕有比较差的临床结局。Objective:To investigate the outcome of infertile patients with clomiphene(CC)resistant polycystic ovary syndrome(PCOS)undergoing in vitro fertilization-embryo transfer(IVF-ET). Methods:A total of 126 PCOS patients who received IVF-ET treatment in the center for reproductive medcine in our hospital were analyzed. According to the responses to CC before IVF-ET,patientes were divided into two groups:The CC resistant group(n=37),the CC response group(n=89). The general situation,the clinical pregnancy rate and abortion rate were compared between these two groups. Results:The body weight and body mass index(BMI)of the CC resistant group were higher than that of CC response group(P<0.05),HOMAIR of the CC resistant group was significantly higher than that of the CC response group(P<0.01),the number of Gn days in the CC resistant group was longer than that of the CC response group(P<0.05).There was no significant difference in the number of oocytes retrieved,normal fertilization rate,good quality embryo rate,number of embryos transferred and OHSS incidence.The clinical pregnancy rate in the CC resistant group was lower than that in the CC response group(P<0.05),and the abortion rate in the CC resistant group was significant higher tha n that in the CC response group(P<0.01). Conclusion:There was a worse outcome during IVF-ET in PCOS patients with resistance to CC than those with response to CC.

关 键 词：多囊卵巢综合征 克罗米芬抵抗 体外受精-胚胎移植 临床结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]