多囊卵巢综合征女性中卵巢过度刺激综合征对卵胞浆内单精子注射结局的影响：一项横断面研究
Impact of ovarian hyperstimulation syndrome on intracytoplasmic sperm injection outcomes in poly-cystic ovarian syndrome women: A cross-sectional study.
作者信息
Jwad Mufeda Ali, Khaleefah Maryam Hussein, Naser Ramih Abd AlFattah
机构信息
Department of Physiology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq.
Department of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq.
出版信息
Int J Reprod Biomed. 2025 May 1;23(2):207-216. doi: 10.18502/ijrm.v23i2.18496. eCollection 2024 May.
BACKGROUND
Polycystic ovarian syndrome (PCOS) is a complex disorder that affects the endocrine, metabolic, and reproductive systems. While controlled ovarian hyperstimulation can increase the number of oocytes retrieved and improve the number of good-quality embryos, it may also negatively affect oocyte maturity, embryo quality, endometrial receptivity, and pregnancy outcomes.
OBJECTIVE
This study aimed to find out if ovarian hyperstimulation syndrome (OHSS) has negative effects on intracytoplasmic sperm injection outcomes in a sample of PCOS women.
MATERIALS AND METHODS
In this cross-sectional study, data of 84 PCOS women who underwent controlled ovarian stimulation using a flexible antagonist protocol-treated intracytoplasmic sperm injection cycles referred to the Infertility Department of Higher Institute for the Diagnosis of Infertility and Assisted Reproduction Techniques, Baghdad, Iraq between January 2020 and December 2023 was extracted from their medical records. Participants were categorized into 2 groups after undergoing controlled ovarian hyperstimulation protocol: PCOS with OHSS (n = 54) and PCOS without OHSS (n = 30). The dosage was tailored based on age, body mass index, and response to previous stimulation cycles, if applicable. The trigger was administered using decapeptyl 0.2 mg alone or in combination with recombinant human chorionic gonadotrophin, depending on the estradiol levels at the time of the trigger.
RESULTS
Significant differences were observed in the duration of stimulation (p = 0.005), oocyte yield (p = 0.001), mature oocytes (p = 0.001), and fertilized oocytes (p = 0.036); however, no significant difference was observed, neither in number of good quality embryos (p = 0.52) nor in pregnancy rate (p = 0.54) after fresh and frozen embryo transfer between the 2 groups.
CONCLUSION
OHSS does not affect the embryo quality or pregnancy rate in PCOS women.
背景
多囊卵巢综合征（PCOS）是一种影响内分泌、代谢和生殖系统的复杂疾病。虽然控制性卵巢过度刺激可增加获卵数量并提高优质胚胎数量，但它也可能对卵母细胞成熟、胚胎质量、子宫内膜容受性和妊娠结局产生负面影响。
目的
本研究旨在探讨卵巢过度刺激综合征（OHSS）对多囊卵巢综合征女性样本卵胞浆内单精子注射结局是否有负面影响。
材料与方法
在这项横断面研究中，从2020年1月至2023年12月转诊至伊拉克巴格达不孕不育诊断与辅助生殖技术高等研究所不孕不育科、采用灵活拮抗剂方案治疗的卵胞浆内单精子注射周期的84例多囊卵巢综合征女性的病历中提取数据。在接受控制性卵巢过度刺激方案后，参与者被分为两组：患有OHSS的PCOS患者（n = 54）和未患有OHSS的PCOS患者（n = 30）。剂量根据年龄、体重指数以及既往刺激周期的反应（如适用）进行调整。根据扳机时的雌二醇水平，使用0.2 mg的曲普瑞林单独或与重组人绒毛膜促性腺激素联合进行扳机注射。
结果
在刺激持续时间（p = 0.005）、卵母细胞产量（p = 0.001）、成熟卵母细胞（p = 0.001）和受精卵母细胞（p = 0.036）方面观察到显著差异；然而，两组之间在新鲜和冷冻胚胎移植后的优质胚胎数量（p = 0.52）和妊娠率（p = 0.54）方面均未观察到显著差异。
结论
OHSS不影响多囊卵巢综合征女性的胚胎质量或妊娠率。
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