Cocksedge Karen A, Li Tin-Chiu, Saravelos Sotiris H, Metwally Mostafa
Reproductive Medicine and Surgery Unit, University of Sheffield, Sheffield Teaching Hospitals, Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, UK.
Reprod Biomed Online. 2008 Jul;17(1):151-60. doi: 10.1016/s1472-6483(10)60304-5.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with recurrent miscarriage. Despite the many studies that have investigated the prevalence of PCOS in recurrent miscarriage, the extent to which PCOS contributes remains highly uncertain. The majority of these studies have used the polycystic ovary morphology alone to define PCOS and the results are extremely variable due to a variety of diagnostic and selection criteria used. Only a very small number of studies have investigated the prevalence of hyperandrogenaemia in recurrent miscarriage. Most crucially, to the authors' knowledge, there is not yet a single publication which has investigated the true prevalence of the complete syndrome of PCOS in recurrent miscarriage using the Rotterdam criteria. Hence there is an urgent need to reappraise the prevalence of PCOS in recurrent miscarriage using the Rotterdam criteria. The possible mechanisms by which PCOS could cause recurrent miscarriage are considered: hyperandrogenaemia, obesity and hyperinsulinaemia are the most likely candidates, although further work is clearly needed. This paper also reviews the possible treatment options for women diagnosed with recurrent miscarriage associated with PCOS. There is some evidence to suggest that weight loss, ovarian drilling and metformin could help to reduce the rate of miscarriage.
多囊卵巢综合征（PCOS）是一种常见的内分泌紊乱疾病，与复发性流产有关。尽管有许多研究调查了复发性流产中PCOS的患病率，但PCOS导致复发性流产的程度仍极不确定。这些研究大多仅使用多囊卵巢形态来定义PCOS，由于使用了各种诊断和选择标准，结果差异极大。只有极少数研究调查了复发性流产中高雄激素血症的患病率。最关键的是，据作者所知，尚无一篇出版物使用鹿特丹标准调查复发性流产中PCOS完整综合征的真实患病率。因此，迫切需要使用鹿特丹标准重新评估复发性流产中PCOS的患病率。文中考虑了PCOS可能导致复发性流产的机制：高雄激素血症、肥胖和高胰岛素血症是最有可能的因素，不过显然还需要进一步研究。本文还综述了被诊断为与PCOS相关的复发性流产的女性可能的治疗选择。有一些证据表明，体重减轻、卵巢打孔和二甲双胍可能有助于降低流产率。
