Tannus Samer, Tan Justin, Son Weon-Young, Dahan Michael-Haim
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University Health Centre (MUHC) Reproductive Centre, 888, Blvd. de Maisonneuve East, suite 200, Montreal, QC, H2L 4S8, Canada.
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
Arch Gynecol Obstet. 2018 Apr;297(4):1037-1042. doi: 10.1007/s00404-017-4642-z. Epub 2017 Dec 30.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. The clinical symptoms of PCOS vary with female age, as older women tend to have lower hyperandrogenic symptoms and many regain regular cycles. In this study, we aimed to estimate the prevalence of PCOS among older women referred for fertility care, describe their clinical characteristics, and compare their reproductive outcomes to those of matched control group.
A retrospective study conducted at a single reproductive center. All women aged ≥ 40, who were referred for in-vitro fertilization (IVF), between the years 2011-2015 were screened for possible inclusion. The PCOS diagnosis (was) made based on the Rotterdam criteria. The reproductive outcomes of the PCOS group were compared to those of matched control with tubal infertility.
During the study period, 1427 women, aged 40 years and over, underwent a total of 2124 IVF cycles. Of these, 72 (5%) women were diagnosed with PCOS. In 69 (95.6%), the PCOS diagnosis was made by a combination of polycystic ovary morphology (PCOM) and anovulation. Compared to women with tubal factor infertility, women with PCOS needed lower doses of gonadotropins, had higher number of retrieved oocytes (16.6 vs. 10.4) and higher number of cycles with embryo cryopreservation (47 vs. 22.9%). This resulted in higher cumulative live birth in the PCOS group (26.3 vs. 15.2%, p = 0.04).
PCOS comprised 5% of the infertility diagnosis in women aged ≥ 40; PCOM and anovulation were the most prominent features. The higher oocyte number resulted in improved cumulative live birth rate.
多囊卵巢综合征（PCOS）是育龄期女性最常见的内分泌紊乱疾病。PCOS的临床症状随女性年龄而异，因为年长女性往往雄激素过多症状较轻，且许多人恢复了规律的月经周期。在本研究中，我们旨在评估因生育问题前来就诊的年长女性中PCOS的患病率，描述她们的临床特征，并将其生殖结局与匹配的对照组进行比较。
在一个单一的生殖中心进行一项回顾性研究。对2011年至2015年间所有年龄≥40岁且因体外受精（IVF）前来就诊的女性进行筛选，以确定是否可能纳入研究。PCOS的诊断基于鹿特丹标准。将PCOS组的生殖结局与因输卵管因素不孕的匹配对照组进行比较。
在研究期间，1427名年龄40岁及以上的女性共进行了2124个IVF周期。其中，72名（5%）女性被诊断为PCOS。在69名（95.6%）女性中，PCOS的诊断是由多囊卵巢形态（PCOM）和无排卵共同确定的。与输卵管因素不孕的女性相比，PCOS女性需要较低剂量的促性腺激素，获取的卵母细胞数量更多（16.6个对10.4个），胚胎冷冻保存的周期数更高（47%对22.9%）。这导致PCOS组的累积活产率更高（26.3%对15.2%，p = 0.04）。
PCOS占40岁及以上女性不孕诊断的5%；PCOM和无排卵是最突出的特征。较高的卵母细胞数量导致累积活产率提高。
