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代谢综合征对接受辅助生殖技术治疗的多囊卵巢综合征不孕妇女控制性卵巢刺激结局的影响。

The effect of metabolic syndrome on controlled ovarian stimulation outcome in infertile women with polycystic ovary syndrome undergoing assisted reproductive technology cycles.

机构信息

Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Endocrinol Metab. 2023 Jan 18;67(1):111-118. doi: 10.20945/2359-3997000000518. Epub 2022 Sep 20.

Abstract

OBJECTIVE

To evaluate the effect of metabolic syndrome (MetS) diagnosis on oocyte quality and pregnancy outcomes in infertile women with polycystic ovary syndrome (PCOS) who undergoing antagonist-controlled ovarian stimulation (COS) and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.

METHODS

This prospective cohort study was conducted from November 2019 to November 2020 across two university-affiliated infertility centers in Iran. The PCOS diagnosis was defined according to the Rotterdam criteria. The patients prior to IVF/ICSI cycles were evaluated for MetS diagnosis. MetS was detected according to the National Cholesterol Education Program/Adult Treatment Panel III with the presence of at least three or more of the specific clinical criteria. The cycle outcomes were compared between MetS and non-MetS groups.

RESULTS

Overall, 68 eligible infertile PCOS patients with MetS diagnosis and 126 without MetS participated. The MetS diagnosis was associated with the increased requirement of gonadotropins and the COS duration significantly (P = 0.001). Although the total numbers of retrieved and MII oocytes, obtained and topquality embryos as well as clinical pregnancy and live birth rates in the MetS group were lower than those of in the non-MetS group, the differences were not statistically significant (P > 0.05). In followup of the obstetrics complications, the rate of preeclampsia was significantly higher in patients with MetS (P = 0.02).

CONCLUSION

MetS diagnosis in PCOS patients was associated with non-significant poor COS and pregnancy outcome. Further studies with larger sample sizes are recommended to clarify the risk of MetS in patients undergoing ART cycles.

摘要

目的

评估代谢综合征(MetS)诊断对接受拮抗剂控制性卵巢刺激(COS)和体外受精/胞浆内单精子注射(IVF/ICSI)周期的多囊卵巢综合征(PCOS)不孕妇女卵母细胞质量和妊娠结局的影响。

方法

本前瞻性队列研究于 2019 年 11 月至 2020 年 11 月在伊朗的两个大学附属不孕不育中心进行。PCOS 的诊断依据 Rotterdam 标准。在 IVF/ICSI 周期前评估患者 MetS 诊断。MetS 根据国家胆固醇教育计划/成人治疗小组 III 标准检测,至少存在三个或更多特定临床标准。比较 MetS 和非 MetS 组的周期结局。

结果

共有 68 名符合条件的患有 MetS 诊断的 PCOS 不孕患者和 126 名无 MetS 的患者参与了研究。MetS 诊断与促性腺激素需求增加和 COS 持续时间显著相关(P=0.001)。尽管 MetS 组的总获卵数、MII 卵数、获得的和优质胚胎数以及临床妊娠率和活产率均低于非 MetS 组,但差异无统计学意义(P>0.05)。在随访产科并发症时,MetS 患者的子痫前期发生率显著更高(P=0.02)。

结论

PCOS 患者的 MetS 诊断与非显著不良的 COS 和妊娠结局相关。建议进行更大样本量的进一步研究,以阐明 MetS 患者在接受 ART 周期时的风险。

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