[体外成熟与体外受精-胚胎移植治疗多囊卵巢综合征不孕女性的临床效果研究]
[Study on clinical effect on infertility women with polycystic ovary syndrome treated by in vitro maturation and in vitro fertilization-embryo transfer].
作者信息
Yu Rong, Lin Jia, Zhao Jun-Zhao, Wang Pei-Yu, Xiao Shi-Quan, Zhang Wei
机构信息
Center of Reproductive Medicine, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.
出版信息
Zhonghua Fu Chan Ke Za Zhi. 2012 Apr;47(4):250-4.
OBJECTIVE
To compare clinical and laboratory outcomes of in vitro maturation (IVM) with in vitro fertilization-embryo transfer (IVF-ET) in treatment of infertility associated with polycystic ovary syndrome (PCOS).
METHODS
From Jan.2007 to Dec.2010, infertile patients with PCOS underwent 701 cycles in First Affiliated Hospital of Wenzhou Medical College were studied retrospectively. Those were divided into 293 cycles of IVM group and 408 cycles of IVF/intra-cytoplasmic sperm injection (ICSI) group. The average transplantation rate, mean number of retrieval oocytes, maturation rate, fertilization rate, cleavage rate, high quality embryo rate, embryo implantation rate, pregnancy rate per transfer, pregnancy outcomes and incidence of ovarian hyperstimulation syndrome (OHSS) of the two methods of treatment were compared between two groups.
RESULTS
There were 275 cycles in IVM group and 342 cycles in IVF/ICSI group established embryo transfer. The transplantation rate was 93.9% (275/293) in IVM group and 83.8% (342/408) in IVF/ICSI, which reached statistical difference (P < 0.01). The maturation rate of 56.64%, cleavage rate of 88.08%, high quality embryo rate of 38.72% and embryo implantation rate of 17.8% in IVM group were significantly lower than 91.09%, 94.91%, 51.50% and 25.4% in IVF/ICSI group (all P < 0.01). The clinical pregnancy rate per transfer were 37.8% (104/275) in IVM group and 44.2% (151/342) in IVF/ICSI group, which did not show statistical difference (P > 0.05). The mean number of oocytes (12.9 ± 6.5 vs. 12.9 ± 7.9) and fertilization rate (76.52% vs. 70.75%) didn't show significant difference between IVM group and IVF/ICSI group (P > 0.05). The 21.3% (87/408) cycles presented mild to moderate OHSS and 2.0% cycles (8/408) presented severe OHSS in IVF/ICSI group. While, no OHSS cycles were observed in IVM group.
CONCLUSION
IVM could get similar clinical pregnancy rates compared with IVF/ICSI in patient with PCOS, however, it can avoid occurrence of OHSS.
目的
比较体外成熟（IVM）与体外受精 - 胚胎移植（IVF - ET）治疗多囊卵巢综合征（PCOS）所致不孕症的临床及实验室结局。
方法
回顾性分析2007年1月至2010年12月在温州医学院附属第一医院接受治疗的701个周期的PCOS不孕患者。将其分为IVM组293个周期和IVF/卵胞浆内单精子注射（ICSI）组408个周期。比较两组两种治疗方法的平均移植率、平均取卵数、成熟率、受精率、卵裂率、优质胚胎率、胚胎着床率、每次移植的妊娠率、妊娠结局及卵巢过度刺激综合征（OHSS）的发生率。
结果
IVM组275个周期、IVF/ICSI组342个周期成功进行胚胎移植。IVM组移植率为93.9%（275/293），IVF/ICSI组为83.8%（342/408），差异有统计学意义（P < 0.01）。IVM组成熟率56.64%、卵裂率88.08%、优质胚胎率38.72%、胚胎着床率17.8%，均显著低于IVF/ICSI组的91.09%、94.91%、51.50%和25.4%（均P < 0.01）。IVM组每次移植的临床妊娠率为37.8%（104/275），IVF/ICSI组为44.2%（151/342），差异无统计学意义（P > 0.05）。IVM组与IVF/ICSI组平均取卵数（12.9 ± 6.5 vs. 12.9 ± 7.9）及受精率（76.52% vs. 70.75%）差异无统计学意义（P > 0.05）。IVF/ICSI组21.3%（87/408）周期出现轻至中度OHSS，2.0%（8/408）周期出现重度OHSS。而IVM组未观察到OHSS周期。
结论
PCOS患者中，IVM与IVF/ICSI相比可获得相似的临床妊娠率，但能避免OHSS的发生。
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