Reproductive Medicine Center, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, P. R. China.
The Subcenter of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi Province, China.
J Ovarian Res. 2023 Oct 13;16(1):201. doi: 10.1186/s13048-023-01290-3.
The factors affecting the cumulative live birth rate (CLBR) of PCOS (Polycystic ovary syndrom) patients who received in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) needs more research for a better outcome.
Here we carried out a retrospective analysis of 1380 PCOS patients who received IVF/ICSI-ET for the first time from January 2014 to December 2016. We divided them into cumulative live birth group (group A) and non-cumulative live birth group (group B) according to whether there were live births.
The conservative cumulative live birth rate was 63.48%. There were 876 cumulative live births (group A) and 504 non-cumulative live births (group B) according to whether the patients had live births or not. Competition analysis showed that duration of infertility, primary/secondary type of infertility, stimulation protocols, starting dose of gonadotrophins and oocyte retrieved numbers were significantly correlated with CLBR. The Cox proportional risk regression model of PCOS patients showed that stimulation protocols had a significant impact on CLBR. Patients in the GnRH (Gonadotropin-releasing hormone)-antagonist protocol group and the mild stimulation protocol had lower CLBR than those in the prolonged GnRH-agonist protocol, which was statistically significant. PCOS patients with the starting dose of gonadotrophins greater than 112.5u had lower CLBR than those with less than 100u, which was statistically significant. Women with 11-15 oocytes and 16-20 oocytes had higher CLBR than women with 1-9 oocytes, which was statistically significant.
When we used Prolonged GnRH-agonist protocol, or the first starting dose of gonadotrophins was 100u-112.5u, or the number of oocytes obtained was 11-15 and 16-20, the CLBR of PCOS patients increased significantly after the 1st oocyte collection.
影响多囊卵巢综合征（PCOS）患者接受体外受精/卵胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）累积活产率（CLBR）的因素需要更多的研究以获得更好的结果。
我们对 2014 年 1 月至 2016 年 12 月首次接受 IVF/ICSI-ET 的 1380 例 PCOS 患者进行了回顾性分析。根据是否有活产，我们将其分为累积活产组（A 组）和非累积活产组（B 组）。
保守的累积活产率为 63.48%。根据患者是否有活产，有 876 例累积活产（A 组）和 504 例非累积活产（B 组）。竞争分析显示，不孕持续时间、原发/继发不孕类型、刺激方案、促性腺激素起始剂量和取卵数与 CLBR 显著相关。PCOS 患者的 Cox 比例风险回归模型显示，刺激方案对 CLBR 有显著影响。与延长 GnRH-激动剂方案相比，GnRH 拮抗剂方案和轻度刺激方案的 PCOS 患者 CLBR 较低，差异有统计学意义。促性腺激素起始剂量大于 112.5u 的 PCOS 患者 CLBR 低于起始剂量小于 100u 的患者，差异有统计学意义。取卵数为 11-15 枚和 16-20 枚的患者 CLBR 高于取卵数为 1-9 枚的患者，差异有统计学意义。
当我们使用延长 GnRH-激动剂方案，或促性腺激素起始剂量为 100u-112.5u，或获得的卵母细胞数为 11-15 和 16-20 时，PCOS 患者在第一次取卵后，CLBR 显著增加。
