Lu Xiu-e, Yang Xiao-fu, Li Mei-gen, Zhou Fu-zhen, Zhu Yi-min, Huang He-feng
Department of Reproduction Endocrinology, The Affiliated Obstetrics and Gynecological Hospital, College of Medicine, Zhejiang University, Hangzhou 310006, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2006 May;35(3):319-22. doi: 10.3785/j.issn.1008-9292.2006.03.016.
To evaluate the outcome of in vitro fertilization embryo transfer (IVF-ET) in treatment of polycystic ovarian syndrome (PCOS) with infertility.
A retrospective analysis was performed from 52 patients with PCOS (PCOS group) and 408 cases with tubal infertility (control group). Both groups underwent IVF-ET treatment from 2001 to 2004. The duration of stimulation, amps of gammaFSH, the level of serum E2, P on the day of HCG injection, the number of oocytes retrieved, the rates of fertilization, cleavage, implantation and pregnancy, the incidence of ovarian hyperstimulation syndrome (OHSS) and cancelled rate of ET were compared between the two groups.
The duration of stimulation and amps of gammaFSH were not significantly different between the two groups. The concentration of serum E2, P on the day of HCG injection, the numbers of oocytes retrieved and cleavaged embryos were significantly higher in PCOS group (P <0.01, <0.05). Fertilization rate was significantly lower in PCOS group (P <0.01). The implantation, pregnancy and miscarriage rates per ET were not statistically significant. The OHSS rates and cancelled rates of ET were higher in PCOS group (P <0.01).
Women with PCOS have a lower fertilization rate compared with those with tubal-factor fertility during IVF-ET. However, more oocytes are recovered and the preimplanted embryo has a normal chance of implantation leading to similar pregnancy rates. The OHSS rates and cancelled rates of ET are higher in PCOS because of a greater number of oocytes developed and a higher level of E2.
评估体外受精胚胎移植（IVF-ET）治疗多囊卵巢综合征（PCOS）所致不孕症的结局。
对52例PCOS患者（PCOS组）和408例输卵管性不孕症患者（对照组）进行回顾性分析。两组均于2001年至2004年接受IVF-ET治疗。比较两组的促排卵时间、γFSH用量、HCG注射日血清E2、P水平、获卵数、受精率、卵裂率、种植率、妊娠率、卵巢过度刺激综合征（OHSS）发生率及胚胎移植取消率。
两组促排卵时间和γFSH用量差异无统计学意义。PCOS组HCG注射日血清E2、P浓度、获卵数及卵裂胚胎数显著高于对照组（P<0.01，<0.05）。PCOS组受精率显著降低（P<0.01）。每次胚胎移植的种植率、妊娠率和流产率无统计学差异。PCOS组OHSS发生率和胚胎移植取消率较高（P<0.01）。
在IVF-ET过程中，PCOS女性的受精率低于输卵管因素不孕女性。然而，PCOS女性可获得更多卵子，植入前胚胎有正常的种植机会，导致妊娠率相似。由于发育的卵子数量较多和E2水平较高，PCOS组OHSS发生率和胚胎移植取消率较高。
