Liu Liu, Tong Xiaomei, Jiang Lingying, Li T C, Zhou Feng, Zhang Songying
Center of Reproductive Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, PR China; Department of Obstetric & Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong.
Center of Reproductive Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, PR China.
Eur J Obstet Gynecol Reprod Biol. 2014 May;176:178-82. doi: 10.1016/j.ejogrb.2014.02.041. Epub 2014 Mar 12.
To investigate if patients with polycystic ovary syndrome (PCOS) who conceived via IVF treatment had a higher miscarriage rate than non-PCOS subjects after controlling for several important confounding variables relating to pregnancy loss.
A retrospective, observational, cohort study including a consecutive series of 564 embryo transfer cycles from PCOS patients and 7494 embryo transfer cycles from non-PCOS patients. Only the first pregnancy arising from IVF treatment was included for subsequent analysis. None of the subjects underwent ovarian diathermy or drilling prior to IVF treatment. Low dose (≤1000mg daily), short term (≤3 weeks) metformin therapy was used in 50 of the 301 PCOS subjects included in the study.
After controlling for the number of embryo transferred, the type of embryos transferred (fresh or frozen-thawed), and the stage of embryo development at the time of transfer, women with PCOS had a consistently higher biochemical pregnancy rate than women without PCOS (fresh single day 3 embryo transfer, 46.7% (7/15) vs. 14.5% (27/186), respectively, p<0.05; frozen-thawed single day 3 embryo transfer, 25.9% (7/27) vs. 6.1% (11/181), p<0.05; fresh double day 3 embryo transfer, 17.1% (12/70) vs. 7.6% (95/1256), p<0.05; frozen-thawed double day 3 embryo transfer, 7.9% (15/189) vs. 3.4% (66/1968), p<0.05). There was no significant difference in the clinical miscarriage rate between the two groups of subjects.
PCOS patients who conceived following IVF treatment had higher biochemical loss than women without PCOS, but the clinical miscarriage rate was no different between the two groups.
在控制了几个与妊娠丢失相关的重要混杂变量后，研究通过体外受精（IVF）治疗受孕的多囊卵巢综合征（PCOS）患者流产率是否高于非PCOS受试者。
一项回顾性观察队列研究，纳入了连续的564个来自PCOS患者的胚胎移植周期和7494个来自非PCOS患者的胚胎移植周期。后续分析仅纳入IVF治疗后的首次妊娠。所有受试者在IVF治疗前均未接受卵巢透热疗法或打孔术。本研究纳入的301例PCOS受试者中有50例使用了低剂量（每日≤1000mg）、短期（≤3周）的二甲双胍治疗。
在控制了移植胚胎数量、移植胚胎类型（新鲜或冻融）以及移植时胚胎发育阶段后，PCOS女性的生化妊娠率始终高于非PCOS女性（新鲜第3天单胚胎移植，分别为46.7%（7/15）和14.5%（27/186），p<0.05；冻融第3天单胚胎移植，25.9%（7/27）和6.1%（11/181），p<0.05；新鲜第3天双胚胎移植，17.1%（12/70）和7.6%（95/1256），p<0.05；冻融第3天双胚胎移植，7.9%（15/189）和3.4%（66/1968），p<0.05）。两组受试者的临床流产率无显著差异。
IVF治疗后受孕的PCOS患者生化妊娠丢失率高于非PCOS女性，但两组的临床流产率无差异。
