Sugiura-Ogasawara Mayumi, Sato Takeshi, Suzumori Nobuhiro, Kitaori Tamao, Kumagai Kyoko, Ozaki Yasuhiko
Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.
Am J Reprod Immunol. 2009 Jan;61(1):62-7. doi: 10.1111/j.1600-0897.2008.00662.x.
It has been a matter of controversy whether the polycystic ovary syndrome (PCOS) is actually a causal factor of miscarriages because of the absence of internationally established criteria. We, therefore, in this study investigated whether PCOS and a polycystic ovary (PCO) morphology have predictive value for subsequent miscarriages using new International and Japanese criteria.
A total of 195 patients with a history of two consecutive first trimester miscarriages and without abnormal chromosomes in either partner, antiphospholipid antibodies or uterine anomalies, were examined. The prospective pregnancy outcome was compared between patients with and without PCOS, PCO morphology, elevated luteinizing hormone (LH), hyperandrogenism and obesity.
Of a total of 195 patients, 56 (28.7%) miscarried subsequently. Three (1.5%) and 12 (6.2%) were diagnosed as suffering from PCOS by Japanese and International criteria respectively. There was no relation between a diagnosis of PCOS, PCO morphology, elevated LH, free testosterone or obesity and the subsequent miscarriage rate.
A routine test for diagnosis of PCOS is not necessary in patients experiencing recurrent miscarriages because none of the related parameters examined in this study predicted subsequent miscarriage.
由于缺乏国际公认的标准,多囊卵巢综合征(PCOS)是否实际上是流产的一个病因一直存在争议。因此,在本研究中,我们使用新的国际和日本标准,调查了PCOS和多囊卵巢(PCO)形态对后续流产是否具有预测价值。
总共检查了195例有连续两次孕早期流产史且夫妻双方染色体均无异常、无抗磷脂抗体或子宫异常的患者。比较了有无PCOS、PCO形态、黄体生成素(LH)升高、高雄激素血症和肥胖的患者的前瞻性妊娠结局。
在总共195例患者中,56例(28.7%)随后流产。根据日本和国际标准,分别有3例(1.5%)和12例(6.2%)被诊断为患有PCOS。PCOS诊断、PCO形态、LH升高、游离睾酮或肥胖与随后的流产率之间没有关系。
对于反复流产的患者,没有必要进行PCOS诊断的常规检查,因为本研究中检查的相关参数均未预测后续流产。