Diamond Michael P, Legro Richard S, Coutifaris Christos, Alvero Ruben, Robinson Randal D, Casson Peter A, Christman Gregory M, Huang Hao, Hansen Karl R, Baker Valerie, Usadi Rebecca, Seungdamrong Aimee, Bates G Wright, Rosen R Mitchell, Schlaff William, Haisenleder Daniel, Krawetz Stephen A, Barnhart Kurt, Trussell J C, Santoro Nanette, Eisenberg Esther, Zhang Heping
Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA; Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI.
Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, PA.
Am J Obstet Gynecol. 2017 Aug;217(2):191.e1-191.e19. doi: 10.1016/j.ajog.2017.04.034. Epub 2017 Apr 26.
While female sexual dysfunction is a frequent occurrence, characteristics in infertile women are not well delineated. Furthermore, the impact of infertility etiology on the characteristics in women with differing androgen levels observed in women with polycystic ovary syndrome and unexplained infertility has not been assessed.
The objective of the study was to determine the characteristics of sexual dysfunction in women with polycystic ovary syndrome and unexplained infertility.
A secondary data analysis was performed on 2 of Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Networks clinical trials: Pregnancy in Polycystic Ovary Syndrome Study II and Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Both protocols assessed female sexual function using the Female Sexual Function Inventory and the Female Sexual Distress Scale.
Women with polycystic ovary syndrome had higher weight and body mass index than women with unexplained infertility (each P < .001), greater phenotypic (Ferriman-Gallwey hirsutism score, sebum score, and acne score; each P < .001), and hormonal (testosterone, free testosterone, and dehydroepiandrosterone; each P < .001) evidence of androgen excess. Sexual function scores, as assessed by the Female Sexual Function Inventory, were nearly identical. The Female Sexual Distress Scale total score was higher in women with polycystic ovary syndrome. The mean Female Sexual Function Inventory total score increased slightly as the free androgen index increased, mainly as a result of the desire subscore. This association was more pronounced in the women with unexplained infertility.
Reproductive-age women with infertility associated with polycystic ovary syndrome and unexplained infertility, despite phenotypic and biochemical differences in androgenic manifestations, do not manifest clinically significant differences in sexual function.
虽然女性性功能障碍很常见，但不孕女性的性功能障碍特征尚未得到很好的描述。此外，多囊卵巢综合征和不明原因不孕女性中，不孕病因对不同雄激素水平女性性功能障碍特征的影响尚未得到评估。
本研究的目的是确定多囊卵巢综合征和不明原因不孕女性性功能障碍的特征。
对尤妮斯·肯尼迪·施赖弗国家儿童健康与人类发展研究所生殖医学合作网络的两项临床试验进行二次数据分析：多囊卵巢综合征妊娠研究II和卵巢刺激后多胎妊娠评估。两项研究方案均使用女性性功能量表和女性性困扰量表评估女性性功能。
多囊卵巢综合征女性的体重和体重指数高于不明原因不孕女性（均P <.001），雄激素过多的表型（费里曼-盖尔韦多毛症评分、皮脂评分和痤疮评分；均P <.001）和激素（睾酮、游离睾酮和脱氢表雄酮；均P <.001）证据更明显。通过女性性功能量表评估的性功能得分几乎相同。多囊卵巢综合征女性的女性性困扰量表总分更高。随着游离雄激素指数增加，女性性功能量表总分略有增加，主要是由于性欲子评分升高。这种关联在不明原因不孕女性中更为明显。
患有多囊卵巢综合征和不明原因不孕的育龄女性，尽管在雄激素表现的表型和生化方面存在差异，但在性功能方面并无临床显著差异。
