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目的探讨多囊卵巢综合征(PCOS)不育患者行体外受精-胚胎移植(IVF-ET)的治疗效果及其影响因素。方法对2006年3月至2009年3月在广州医学院第三附属医院生殖医学中心行IVF的PCOS不孕患者作回顾性分析,观察组(A组)为PCOS不孕患者120例132周期,对照组(B组)为双侧输卵管梗阻不孕患者343例382周期,比较两组HCG日雌二醇(E2)、获卵数、受精率、优质胚胎数、种植率、临床妊娠率、活产率、周期取消率、卵巢过度刺激综合征(OHSS)发生率。PCOS患者根据BMI分为正常体重组(C组)及超重组(D组),比较两组妊娠结局。结果 A、B两组促性腺激素(Gn)用量及HCG日E2水平、每移植周期临床妊娠率、流产率、活产率差异无统计学意义(P>0.05);A组与B组比较Gn用时较长,获卵数较多,受精率、卵裂率较高,优质胚胎数较多,种植率较低,OHSS发生率、周期取消率较高,差异有统计学意义(P<0.05)。D组与C组比较,Gn总量较多、用时较长,HCG日E2峰值较低,获卵数、优质胚胎数较少,受精率较低,差异有统计学意义(P<0.05);种植率较低,流产率、周期取消率及OHSS发生率较高,但差异无统计学意义(P>0.05)。结论 IVF-ET是PC0S不孕患者的一种有效治疗方法,但应积极预防OHSS;肥胖及胰岛素抵抗可能对妊娠结局产生不良影响。
Objective To investigate the therapeutic effect and its influencing factors of in vitro fertilization and embryo transfer (IVF-ET) in infertile women with polycystic ovary syndrome (PCOS). Methods From March 2006 to March 2009, we retrospectively analyzed the infertility patients with PCOS who underwent IVF in the Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical College from March 2006 to March 2009. The observation group (group A) The control group (group B) was 343 patients with 382 cycles of bilateral tubal obstruction infertility. The E2, estrogen, fertilization rate, number of high quality embryos, implantation rate, clinical pregnancy rate and survival rate Yield, Cycle Cancellation Rate, Ovarian Hyperstimulation Syndrome (OHSS) Incidence. According to BMI, patients with PCOS were divided into normal weight group (C group) and overweight group (D group). Pregnancy outcomes were compared between the two groups. Results There was no significant difference in the pregnancy rate, miscarriage rate and live birth rate between the two groups (Group A and B) and E2 level on the HCG day (P> 0.05). There was no significant difference in Gn The number of oocytes was higher, the rate of cleavage was higher, the number of high quality embryos was larger, the implantation rate was lower, the incidence of OHSS and cycle cancellation rate were higher, the difference was statistically significant (P <0.05) . Compared with group C, group D had more total amount of Gn, longer time, lower E2 peak on HCG day, fewer oocytes, lower number of high quality embryos and lower fertilization rate, the difference was statistically significant (P <0.05). The rate of abortion, abortion rate and OHSS were higher, but the difference was not statistically significant (P> 0.05). Conclusion IVF-ET is an effective treatment for PCOS infertility patients, but should be actively prevented OHSS; obesity and insulin resistance may have adverse effects on pregnancy outcome.