Ashkenazi J, Farhi J, Orvieto R, Homburg R, Dekel A, Feldberg D, Ben Rafael Z
Department of Obstetrics and Gynecology, Golda Meir Medical Center, Hasharon Hospital, Petah Tikva, Israel.
Fertil Steril. 1995 Sep;64(3):564-7. doi: 10.1016/s0015-0282(16)57793-0.
To evaluate the outcome of oocytes donated by women with polycystic ovarian syndrome (PCOS) compared with oocytes donated by women with mechanical infertility.
A retrospective study.
The outcome of 159 oocyte donation cycles with oocyte donated by PCOS patients were compared with 69 oocyte donation cycles with oocytes donated by patients with mechanical infertility. We compared the stimulation protocols in the donors to assess if the combination of GnRH analogue (GnRH-a), FSH, and hMG has an advantage over FSH and hMG alone with respect to their effect on fertilization and implantation rates in oocyte donation cycles.
When treated with GnRH-a, pregnancy rates in PCOS and mechanical infertility donors were higher than those treated with FSH and hMG alone. The comparison between PCOS and mechanical factor oocyte recipients revealed no significant difference in the pregnancy and abortion rates, but the oocytes of patients with PCOS that were exposed to GnRH-a had a significantly higher implantation rate than those not exposed to GnRH-a.
Oocytes obtained from PCOS patients had a fertilization potential equal to oocytes obtained from mechanical infertility donors. Furthermore, because the oocytes of patients with PCOS exposed to GnRH-a had a significantly higher implantation rate, a detrimental role of high LH on oocyte quality seems probable. However, because PCOS has a high familial prevalence, some reservations may arise due to a possible propagation of the problem in the next generation of oocyte donation programs.
评估多囊卵巢综合征(PCOS)女性捐赠的卵母细胞与机械性不孕女性捐赠的卵母细胞的结局。
一项回顾性研究。
将159个接受PCOS患者捐赠卵母细胞的卵母细胞捐赠周期的结局与69个接受机械性不孕患者捐赠卵母细胞的卵母细胞捐赠周期的结局进行比较。我们比较了供体的促排卵方案,以评估促性腺激素释放激素类似物(GnRH-a)、促卵泡激素(FSH)和人绝经期促性腺激素(hMG)联合使用相对于单独使用FSH和hMG对卵母细胞捐赠周期中受精率和着床率的影响是否具有优势。
使用GnRH-a治疗时,PCOS供体和机械性不孕供体的妊娠率高于单独使用FSH和hMG治疗时。PCOS和机械因素卵母细胞受体之间的比较显示,妊娠率和流产率无显著差异,但暴露于GnRH-a的PCOS患者的卵母细胞着床率显著高于未暴露于GnRH-a的患者。
从PCOS患者获得的卵母细胞的受精潜力与从机械性不孕供体获得的卵母细胞相当。此外,由于暴露于GnRH-a的PCOS患者的卵母细胞着床率显著更高,高促黄体生成素(LH)对卵母细胞质量可能具有有害作用。然而,由于PCOS具有较高的家族患病率,在下一代卵母细胞捐赠计划中可能会因该问题的可能传播而产生一些顾虑。