Bayram Neriman, van Wely Madelon, van der Veen Fulco, Bossuyt Patrick M M, Nieuwkerk Pythia
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
Fertil Steril. 2005 Aug;84(2):420-5. doi: 10.1016/j.fertnstert.2005.02.026.
To investigate patient preferences and trade-offs for laparoscopic electrocautery of the ovaries relative to ovulation induction with recombinant FSH (rFSH) in patients with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS).
Assessment of preferences and trade-offs in a randomized controlled trial.
Academic hospital.
PATIENT(S): Thirty-two CC-resistant patients with PCOS who had been randomly assigned to either laparoscopic electrocautery of the ovaries or ovulation induction with rFSH and 32 control patients with PCOS under treatment with CC.
INTERVENTION(S): Preference for laparoscopic electrocautery relative to rFSH was established during an interview. Trade-offs between treatment burden and effectiveness were evaluated by varying hypothetical pregnancy rates after laparoscopic electrocautery until patients switched in their initial preference.
MAIN OUTCOME MEASURE(S): Preference for laparoscopic electrocautery of the ovaries; trade-off between burden and effectiveness of treatment.
RESULT(S): The majority of the patients would prefer electrocautery of the ovaries over ovulation induction with rFSH if both treatment strategies resulted in similar pregnancy rates. However, most patients were willing to trade off their preference for increased effectiveness: the percentage of patients who preferred electrocautery over rFSH sharply declined when the difference in hypothetical pregnancy rates was more than 5% in favor of rFSH.
CONCLUSION(S): Patients with polycystic ovary syndrome are well able to express an informed preference for laparoscopic electrocautery of the ovaries or ovulation induction with rFHS. Preferences are guided by features of the respective treatments but seem to be dominated by their effectiveness and safety.
探讨对于枸橼酸氯米芬（CC）抵抗的多囊卵巢综合征（PCOS）患者，与使用重组促卵泡激素（rFSH）进行促排卵相比，患者对腹腔镜卵巢电灼术的偏好及权衡。
在一项随机对照试验中评估偏好及权衡。
学术医院。
32例CC抵抗的PCOS患者，已被随机分配至腹腔镜卵巢电灼术组或rFSH促排卵组，以及32例接受CC治疗的PCOS对照患者。
在访谈中确定相对于rFSH，患者对腹腔镜电灼术的偏好。通过改变腹腔镜电灼术后的假设妊娠率来评估治疗负担与有效性之间的权衡，直至患者改变其初始偏好。
对腹腔镜卵巢电灼术的偏好；治疗负担与有效性之间的权衡。
如果两种治疗策略导致相似的妊娠率，大多数患者会更喜欢卵巢电灼术而非rFSH促排卵。然而，大多数患者愿意为提高有效性而放弃其偏好：当假设妊娠率有利于rFSH的差异超过5%时，比起rFSH更喜欢电灼术的患者百分比急剧下降。
多囊卵巢综合征患者能够明智地表达对腹腔镜卵巢电灼术或rFSH促排卵的偏好。偏好受各自治疗特征的引导，但似乎主要由其有效性和安全性主导。
