Urman B, Fluker M R, Yuen B H, Fleige-Zahradka B G, Zouves C G, Moon Y S
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
Fertil Steril. 1992 Jun;57(6):1269-73. doi: 10.1016/s0015-0282(16)55086-9.
To assess the outcome of in vitro fertilization and embryo transfer (IVF-ET) in women with refractory polycystic ovarian syndrome (PCOS).
Retrospective case series with an age-matched control group.
Ovulation induction and IVF programs in a tertiary referral center.
Nine patients with PCOS who failed standard ovulation induction treatment (clomiphene citrate plus greater than or equal to 6 ovulatory human menopausal gonadotropin [hMG] cycles) underwent 19 cycles of IVF-ET. Forty age-matched tubal factor patients who completed 40 cycles of IVF-ET served as a control group.
Demographic features and IVF-ET cycle characteristics were compared using Student's t-test and Fisher's exact test.
Cycles of IVF-ET in patients with PCOS were associated with higher estradiol levels (5,222 versus 4,009 pmol/L), lower hMG requirements (15.8 versus 19.6 vials), greater numbers of oocytes (7.6 versus 5.6), and lower fertilization rates (56% versus 75%) compared with tubal factor cycles (P less than 0.05). However, the number of embryos transferred (3.9 versus 4.0) and the clinical pregnancy rate per embryo transfer (24% versus 25%) did not differ significantly between the two groups.
These results suggest that conception failure after six or more ovulatory hMG cycles in patients with PCOS does not adversely affect subsequent IVF performance.
评估难治性多囊卵巢综合征（PCOS）女性体外受精-胚胎移植（IVF-ET）的结局。
设有年龄匹配对照组的回顾性病例系列研究。
一家三级转诊中心的促排卵和IVF项目。
9例PCOS患者，她们在标准促排卵治疗（枸橼酸氯米芬加≥6个排卵周期的人绝经期促性腺激素[hMG]）失败后接受了19个周期的IVF-ET。40例年龄匹配的输卵管因素患者完成了40个周期的IVF-ET，作为对照组。
使用学生t检验和Fisher精确检验比较人口统计学特征和IVF-ET周期特征。
与输卵管因素周期相比，PCOS患者的IVF-ET周期中雌二醇水平较高（5222对4009 pmol/L），hMG需求量较低（15.8对19.6瓶），卵母细胞数量较多（7.6对5.6），受精率较低（56%对75%）（P<0.05）。然而，两组之间移植胚胎数（3.9对4.0）和每次胚胎移植的临床妊娠率（24%对25%）差异无统计学意义。
这些结果表明，PCOS患者在6个或更多排卵周期的hMG治疗后受孕失败不会对随后的IVF表现产生不利影响。
