Selçuk Selçuk, Özkaya Enis, Eser Ahmet, Kuyucu Melda, Kutlu Hüseyin Tayfun, Devranoğlu Belgin, Sofuoğlu Kenan, Dayıcıoğlu Vedat Erkan
Zeynep Kamil Women and Children's Diseases Education and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Medistate Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2016 Mar;13(1):1-6. doi: 10.4274/tjod.90094. Epub 2016 Mar 10.
The aim of this study was to investigate whether polycystic ovary syndrome (PCOS) phenotype without polycystic ovaries (PCO) differs in terms of in vitro fertilization (IVF) outcomes compared with classic phenotypes.
This retrospective controlled study included 262 patients who underwent IVF treatment with an indication of unexplained or tubal factor infertility (control group), ovulatory patients with PCO morphology (group 1), PCOS phenotype with oligoanovulation and hyperandrogenemia (group 2), PCOS phenotype with PCO morphology and oligoanovulation (group 3). Outcomes and baseline characteristics of IVF-embryo transfer treatments were compared among all groups.
PCOS phenotype without PCO morphology had similar IVF stimulation characteristics compared with classic phenotypes; however, a higher total gonadotropin dose was needed to achieve similar results compared with patients with PCO morphology with or without PCOS. Basal follicle-stimulating hormone level (beta coefficient=0.207, p=0.003), group (beta coefficient=-0.305, p<0.001) and age (beta coefficient=0.311, p<0.001) were significantly associated with the total gonadotropin dose. The number of good quality embryo on transfer day was significantly lower in patients with isolated PCO morphology and PCO morphology with oligoanovulation than in those with PCOS phenotype without PCO morphology.
PCO morphology provides easier stimulation, whereas hyperandrogenemia provides better results as good quality embryos. However, the end point is similar in terms of biochemical, clinical, and ongoing pregnancy rates.
本研究旨在调查无多囊卵巢（PCO）的多囊卵巢综合征（PCOS）表型与经典表型相比，在体外受精（IVF）结局方面是否存在差异。
这项回顾性对照研究纳入了262例接受IVF治疗的患者，这些患者的适应症为不明原因或输卵管因素不孕（对照组）、具有PCO形态的排卵患者（第1组）、伴有排卵稀少和高雄激素血症的PCOS表型患者（第2组）、具有PCO形态和排卵稀少的PCOS表型患者（第3组）。比较了所有组IVF-胚胎移植治疗的结局和基线特征。
无PCO形态的PCOS表型与经典表型相比，具有相似的IVF刺激特征；然而，与有或无PCOS的PCO形态患者相比，需要更高的总促性腺激素剂量才能获得相似的结果。基础促卵泡激素水平（β系数=0.207，p=0.003）、组别（β系数=-0.305，p<0.001）和年龄（β系数=0.311，p<0.001）与总促性腺激素剂量显著相关。单纯PCO形态和伴有排卵稀少的PCO形态患者移植日优质胚胎数量明显低于无PCO形态的PCOS表型患者。
PCO形态提供了更易于刺激的条件，而高雄激素血症作为优质胚胎可带来更好的结果。然而，在生化、临床和持续妊娠率方面终点相似。
