Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, 28 Yonkeun-dong, Chongno-gu, Seoul 110-744, South Korea.
Arch Gynecol Obstet. 2010 Aug;282(2):199-205. doi: 10.1007/s00404-010-1401-9. Epub 2010 Feb 25.
This study was performed to compare the outcomes of controlled ovarian stimulation (COH) and IVF between women with PCOS and those with sonographic PCO-only in GnRH antagonist cycles.
This was a retrospective study of women with PCOS (n = 42) and those with sonographic PCO-only (n = 54) undergoing IVF. Responses to COH, adverse events such as severe ovarian hyperstimulation syndrome (OHSS), embryological and pregnancy outcomes were compared between the two groups using GnRH antagonist cycles and between GnRH agonist and antagonist protocols in the two groups, respectively.
There were no differences in the duration of stimulation, dose of gonadotropins used, E(2) level on hCG day, numbers of retrieved oocytes, and incidence of sever OHSS between PCOS and sonographic PCO-only groups, which was also observed both in GnRH agonist and antagonist subgroups. Pregnancy rates between PCOS and sonographic PCO-only groups in GnRH agonist (21.7 vs. 34.4%, P = 0.238) and antagonist (26.3 vs 22.7%, P = 0.537) subgroups did not differ. In regard to COH regimen, GnRH agonist long protocols showed higher responses than antagonist protocols both in PCOS group [number of retrieved oocytes (13.2 +/- 5.8 vs. 8.2 +/- 3.2, P < 0.001)] and sonographic PCO-only group [number of retrieved oocytes (13.7 +/- 5.2 vs. 9.2 +/- 6.7, P = 0.008); E(2) level on hCG day (3,005.1 +/- 1,317.1 vs. 1,525.9 +/- 738.6 pg/mL, P < 0.001)].
Women with PCOS and sonographic PCO-only may have similar outcome during COH cycle for IVF.
本研究旨在比较接受 GnRH 拮抗剂周期治疗的多囊卵巢综合征（PCOS）患者和单纯超声多囊卵巢（PCO）患者控制性卵巢刺激（COH）和体外受精（IVF）的结局。
这是一项回顾性研究，纳入了 42 名 PCOS 患者和 54 名单纯超声多囊卵巢患者，比较了两组患者在 GnRH 拮抗剂周期下的 COH 反应、严重卵巢过度刺激综合征（OHSS）等不良事件、胚胎学和妊娠结局。同时，分别比较了两组中 GnRH 激动剂和拮抗剂方案之间的这些结果。
PCOS 组和单纯超声多囊卵巢组的刺激持续时间、使用的促性腺激素剂量、HCG 日 E2 水平、获卵数和严重 OHSS 发生率均无差异，这在 GnRH 激动剂和拮抗剂亚组中也观察到。在 GnRH 激动剂（21.7% vs. 34.4%，P=0.238）和拮抗剂（26.3% vs. 22.7%，P=0.537）亚组中，PCOS 组和单纯超声多囊卵巢组的妊娠率也没有差异。关于 COH 方案，GnRH 激动剂长方案在 PCOS 组[获卵数（13.2±5.8 个 vs. 8.2±3.2 个，P<0.001）]和单纯超声多囊卵巢组[获卵数（13.7±5.2 个 vs. 9.2±6.7 个，P=0.008）；HCG 日 E2 水平（3005.1±1317.1 pg/ml vs. 1525.9±738.6 pg/ml，P<0.001）]中均显示出比拮抗剂方案更高的反应。
在 IVF 的 COH 周期中，PCOS 患者和单纯超声多囊卵巢患者可能具有相似的结局。
