PCOS不孕患者行IVF-ET促排卵治疗后卵巢反应性低下影响因素分析  

Analysis of the influencing factors of the low ovarian response of infertile patients with polycystic ovary syndrome after in vitro fertilization-embryo transfer

作　　者：郝培培 刘元伟 黄坚 孙文超 HAO Peipei;LIU Yuanwei;HUANG Jian;SUN Wenchao(Hangzhou Obstetrics and Gynecology Hospital,Zhejiang Province,310000)

机构地区：[1]浙江省杭州市妇产科医院,310000

出　　处：《中国计划生育学杂志》2024年第11期2594-2597,共4页Chinese Journal of Family Planning

基　　金：浙江省中医药管理局共建科技计划项目(G2Y-2J-kJ-23089)。

摘　　要：目的:探究多囊卵巢综合征(PCOS)不孕行体外受精-胚胎移植术(IVF-ET)患者长方案超促排卵后卵巢反应性低下的相关因素。方法:回顾性分析2018年9月1日-2023年9月1日本院收治的PCOS不孕患者128例,均接受IVF-ET长方案超促排卵治疗;经过降调、超促排,取卵等相应治疗结束后记录卵巢反应性情况;采集患者基线资料。根据干预后排卵数分为A组(获取卵数≥4个)以及B组(获取卵数≤3个);单因素分析卵巢反应性不同组各临床资料差异,logistic多因素分析探究IVF-ET患者长方案超促排卵后卵巢低反应性的风险因素。结果:128例中,A组71例、B组57例。单因素分析显示,两组体重、体质指数、合并胰岛素抵抗占比存在差异(P<0.05);多因素分析,患者体质指数≥25.0 kg/m^(2)、合并胰岛素抵抗是造成PCOS不孕患者接受IVF-ET长方案超促排卵治疗后卵巢反应低下的独立危险因素(P<0.05)。结论:患者体质指数高、合并胰岛素抵抗是PCOS不孕患者IVF-ET中长方案超促排卵后卵巢反应性偏低的独立危险因素,临床应予以关注并早期干预,以获得较好的获卵结果。Objective:To explore the related factors of the low ovarian response(LOR)of infertile patients with polycystic ovary syndrome(PCOS)after ovulation induction by long-term superovulation during in vitro fertilization-embryo transfer(IVF-ET).Methods:A total of 128 infertile patients with PCOS who had been given ovulation induction by long-term superovulation during IVF-ET between September 1,2018to September 1,2023were analyzed retrospectively.All the patients had received treatment of down-regulation,superovulation and oocyte retrieval,and then the ovarian response of the patients was recorded.The baseline data of the patients were collected.According to the number of the of eggs retrieved after intervention,these patients were divided into group A(patients with the numbers of retrieved oocytes≥4)and group B(patients with the numbers of retrieved oocytes<4).Univariate analysis was used to compare the clinical data of the patients with different ovarian response.Logistic multivariate analysis was used to explore the risk factors of the LOR of the patients after the long protocol for ovulation induction during IVF-ET.Results:In 128 patients,there were 71cases in group A and 57cases in group B.Univariate analysis showed that there were significant differences in the body weight,the body mass index and the proportion of the complication with insulin resistance of the patients between the two groups(P<0.05).Multivariate analysis showed that the body mass index(BMI)≥25.0kg/m^(2)and the complication with insulin resistance of the infertile patients with PCOS were the independent risk factors of their LOR after the long protocol for ovulation induction during IVF-ET(P<0.05).Conclusion:The high BMI and the complication with insulin resistance of the infertile patients with PCOS are their independent risk factors of their LOR after the long protocol for ovulation induction during IVF-ET,so the early intervention for the patients should be paid to attention in clinic in order to obtain the better egg retrieval results.

关 键 词：多囊卵巢综合征不孕 体外受精-胚胎移植术 长效促排治疗 卵巢反应性低下 影响因素 

分 类 号：R714.8[医药卫生—妇产科学]