Yanagihara Yasuho, Tanaka Atsushi, Nagayoshi Motoi, Tanaka Izumi, Shinohara Rina, Fukushima Fumihisa, Tanaka Akihiro, Ohno Motoharu, Yamaguchi Takashi, Itakura Atsuo
Department of Obstetrics and Gynecology Saint Mother Clinic Kitakyushu Japan.
Department of Obstetrics and Gynecology Juntendo University School of Medicine Bunkyo-ku Japan.
Reprod Med Biol. 2021 Nov 25;21(1):e12429. doi: 10.1002/rmb2.12429. eCollection 2022 Jan.
To analyze the therapeutic efficacy of a modified controlled ovarian stimulation (COS) protocol for polycystic ovary syndrome (PCOS) that does not cause ovarian hyperstimulation syndrome (OHSS) while maintaining oocyte quality.
This study is a retrospective cohort study of reproductive medicine at St. Mother Clinic. We analyzed ART clinical outcomes, embryonic development, and hormone levels in 175 PCOS patients treated with four COS (GnRH agonist based long protocol, Group A; GnRH antagonist protocol with HCG trigger, Group B; GnRH antagonist protocol with GnRH agonist trigger, Group C, and the modified COS group) between 2010 and 2021.
Of 175 patients with PCOS, 45 and 130 patients underwent 47 and 136 oocyte retrieval cycles, 75 and 250 embryo transfer cycles with the modified COS, and with conventional methods, respectively. The cumulative pregnancy rate at one trial was a significantly higher result than in Group A and higher than in Groups B and C (cumulative pregnancy rate at one trial of Group A, B, C, and modified COS: 40.0%, 54.5%, 56.3%, and 72.3%, respectively). With this method, not clinically problematic OHSS and higher clinical outcomes than in conventional methods were observed.
This modified COS can significantly improve clinical outcomes and eliminate OHSS.
分析一种改良的控制性卵巢刺激（COS）方案对多囊卵巢综合征（PCOS）的治疗效果，该方案在维持卵母细胞质量的同时不会引起卵巢过度刺激综合征（OHSS）。
本研究是在圣母诊所进行的一项生殖医学回顾性队列研究。我们分析了2010年至2021年间175例接受四种COS方案（基于GnRH激动剂的长方案，A组；HCG触发的GnRH拮抗剂方案，B组；GnRH激动剂触发的GnRH拮抗剂方案，C组，以及改良COS组）治疗的PCOS患者的辅助生殖技术（ART）临床结局、胚胎发育和激素水平。
175例PCOS患者中，45例和130例患者分别接受改良COS和传统方法进行了47次和136次取卵周期、75次和250次胚胎移植周期。一次试验的累积妊娠率显著高于A组，且高于B组和C组（A组、B组、C组和改良COS组一次试验的累积妊娠率分别为40.0%、54.5%、56.3%和72.3%）。采用这种方法，未观察到临床上有问题的OHSS，且临床结局优于传统方法。
这种改良的COS可显著改善临床结局并消除OHSS。
