Thakre Nisha, Homburg Roy
Homerton Fertility Centre, Homerton University Hospital Foundation Trust , London , UK.
Expert Rev Endocrinol Metab. 2019 Sep;14(5):315-319. doi: 10.1080/17446651.2019.1631797. Epub 2019 Jun 26.
: Polycystic ovarian syndrome (PCOS) is the commonest endocrinopathy affecting women in the reproductive age group. The prevalence may vary from 8.7% to 17% depending on the clinical criteria used. PCOS women having IVF presents multiple challenges ranging from a poor to an exaggerated response, poor egg to follicle ratio, poor fertilisation, poor blastocyst conversion and ovarian hyperstimulation syndrome. Ovarian stimulation should be planned with attention paid to the AMH, antral follicle count and LH in particular. The dose of the stimulating gonadotrophin should be planned to achieve an optimal response during a GnRH antagonist cycle. : We obtained evidence from chapters, case studies, practice committee reports, randomised controlled trials, Cochrane and systematic reviews. : IVF for PCOS is challenging. We have reached an understanding of careful low dose stimulation of ovaries considering AMH and antral follicle count. PCOS women should have the GnRH agonist trigger and freezing of embryos. Segmentation of an IVF cycle in PCOS woman makes it safer and has better outcome.
多囊卵巢综合征（PCOS）是影响育龄女性的最常见内分泌疾病。根据所采用的临床标准，其患病率可能在8.7%至17%之间变化。接受体外受精（IVF）的PCOS女性面临多种挑战，包括反应不良至过度反应、卵子与卵泡比例不佳、受精不良、囊胚转化率低以及卵巢过度刺激综合征。卵巢刺激方案的制定应特别关注抗缪勒管激素（AMH）、窦卵泡计数和促黄体生成素（LH）。在促性腺激素释放激素（GnRH）拮抗剂周期中，应规划刺激促性腺激素的剂量以实现最佳反应。
我们从章节、案例研究、实践委员会报告、随机对照试验、Cochrane综述和系统评价中获取证据。
PCOS患者的IVF具有挑战性。我们已达成共识，即考虑到AMH和窦卵泡计数，对卵巢进行谨慎的低剂量刺激。PCOS女性应采用GnRH激动剂触发并冷冻胚胎。对PCOS女性的IVF周期进行分段会使其更安全且结局更好。
