Keltz M D, Jones E E, Duleba A J, Polcz T, Kennedy K, Olive D L
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Fertil Steril. 1995 Sep;64(3):568-72. doi: 10.1016/s0015-0282(16)57794-2.
To investigate the prognostic significance of baseline ovarian cysts after luteal phase GnRH agonist (GnRH-a) administration for IVF-ET.
All nondonor IVF-ET cycles in one program in which luteal phase GnRH-a was administered between July 1993 and January 1994 were assessed for the formation of baseline ovarian cysts defined as a mean diameter > or = 15 mm. Outcome data from the IVF cycles were compared between patients with and without baseline ovarian cysts.
Of 78 IVF cycles, baseline cysts > or = 15 mm were noted in 26 cycles. Cycles in which cysts were formed were associated with significantly older patients with significantly higher baseline FSH values. Cycles in which cysts were present demonstrated fewer follicles, retrieved oocytes, and embryos. Cyst cycles also demonstrated a lower peak E2 level, implantation rate, and clinical pregnancy rate (PR) per initiated cycle (7.7% versus 32.7%). Cyst cycles also demonstrated a higher cancellation rate. Logistic regression modeling, accounting for age, confirmed significantly lower clinical PRs in cycles with a baseline cyst.
Baseline cyst formation after luteal phase GnRH-a administration is both a marker for poor responders and a reliable predictor of poor stimulation and low PRs in a given IVF-ET cycle.
探讨黄体期给予促性腺激素释放激素激动剂（GnRH-a）后基线卵巢囊肿对体外受精-胚胎移植（IVF-ET）预后的意义。
对1993年7月至1994年1月在一个项目中进行的所有非供体IVF-ET周期进行评估，这些周期在黄体期给予GnRH-a，以确定平均直径≥15mm的基线卵巢囊肿的形成情况。比较有和没有基线卵巢囊肿患者的IVF周期结局数据。
在78个IVF周期中，26个周期发现基线囊肿≥15mm。形成囊肿的周期与年龄显著较大、基线促卵泡激素（FSH）值显著较高的患者相关。存在囊肿的周期显示卵泡、回收的卵母细胞和胚胎较少。囊肿周期的每个启动周期的峰值雌二醇（E2）水平、着床率和临床妊娠率（PR）也较低（7.7%对32.7%）。囊肿周期的取消率也较高。经逻辑回归建模，校正年龄后，证实有基线囊肿的周期临床PR显著较低。
黄体期给予GnRH-a后基线囊肿的形成既是反应不良者的一个标志，也是特定IVF-ET周期中刺激不良和低PR的可靠预测指标。
