Franks Stephen, Roberts Ruth, Hardy Kate
Institute of Reproductive and Developmental Biology, Wolfson and Weston Research Centre for Family Health, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.
Reprod Biomed Online. 2003 Mar;6(2):181-4. doi: 10.1016/s1472-6483(10)61708-7.
The systemic endocrine environment during the later stages of follicle development has a crucial role in co-ordinating follicular and oocyte maturation before ovulation. Polycystic ovary syndrome (PCOS) is associated with abnormal circulating hormones, abnormal peri-follicular vascularity and significant abnormalities of granulosa cell function. After induction of ovulation, fertilization rates in vivo in women with PCOS are normal, but there is an increased risk of early pregnancy loss, particularly in obese patients. After in-vitro maturation of oocytes or following ovulation induction for IVF, oocyte and embryo quality in vitro are not obviously impaired in PCOS. In some reports however, specific endocrine abnormalities, such as hyperinsulinaemia/insulin resistance, have been noted to be associated with reduced fertilization rates and abnormal early embryonic development.
卵泡发育后期的全身内分泌环境在排卵前协调卵泡和卵母细胞成熟过程中起着关键作用。多囊卵巢综合征(PCOS)与循环激素异常、卵泡周围血管异常以及颗粒细胞功能显著异常有关。诱导排卵后,PCOS女性体内的受精率正常,但早期妊娠丢失风险增加,尤其是肥胖患者。卵母细胞体外成熟后或IVF诱导排卵后,PCOS患者的卵母细胞和胚胎体外质量并未明显受损。然而,在一些报告中,已注意到特定的内分泌异常,如高胰岛素血症/胰岛素抵抗,与受精率降低和早期胚胎发育异常有关。