Merviel P, Bouée S, Ménard M, Le Martelot M-T, Roche S, Lelièvre C, Chabaud J-J, Jacq C, Drapier H, Beauvillard D
Fédération d'assistance médicale à la procréation, CHRU de Brest, hôpital Morvan, 2, avenue Foch, 29200 Brest, France.
Fédération d'assistance médicale à la procréation, CHRU de Brest, hôpital Morvan, 2, avenue Foch, 29200 Brest, France.
Gynecol Obstet Fertil Senol. 2017 Nov;45(11):623-631. doi: 10.1016/j.gofs.2017.10.001.
Polycystic ovarian syndrome (PCOS) is a frequent pathology in the young woman, linking infertility to a metabolic disease. Initial support will include a plan (in the case of overweight or obesity) to lose at least 5 to 10% of the weight. Subsequently, clomiphene citrate is the first treatment for ovulation induction with pregnancy rates of 40 to 80% after 6 cycles. If there is resistance to clomiphene citrate, the choice will be between the ovarian drilling (50-60% of pregnancy in the year following, including the half spontaneous) or ovarian stimulation with gonadotropins. The risk of ovarian stimulation in these women is hyperstimulation and multiple pregnancies. We also discuss the place of the GnRH pulsatile administration, insulin-sensitizers, in vitro fertilization and in vitro maturation in these women. Once infertility support, these women should be long-term followed because of the neoplasic and cardiovascular risks they present.
多囊卵巢综合征（PCOS）是年轻女性中的常见病症，它将不孕症与一种代谢性疾病联系起来。初步支持措施将包括一项（针对超重或肥胖情况）减重至少5%至10%的计划。随后，枸橼酸氯米芬是诱导排卵的首选治疗方法，6个周期后妊娠率为40%至80%。如果对枸橼酸氯米芬有抵抗，选择将在卵巢打孔术（术后一年妊娠率为50 - 60%，包括一半自然妊娠）或使用促性腺激素进行卵巢刺激之间。这些女性进行卵巢刺激的风险是卵巢过度刺激和多胎妊娠。我们还讨论了GnRH脉冲给药、胰岛素增敏剂、体外受精和体外成熟在这些女性中的应用。一旦给予不孕症支持，由于这些女性存在肿瘤和心血管风险，应进行长期随访。
