Wada I, Matson P L, Macnamee M C, Brinsden P R, Lieberman B A
Bourn Hall Clinic, Cambridge, UK.
Hum Reprod. 1994 Jun;9(6):1077-80. doi: 10.1093/oxfordjournals.humrep.a138636.
Fertile Yoruba women from western Nigeria have a much higher incidence of naturally conceived multizygotic twin and triplet pregnancies than Caucasians. The objective of the present study was to determine whether there are differences between infertile Yoruba and Caucasian women in terms of ovarian response in stimulate cycles for assisted conception. A total of 11 Yoruba women were scheduled for 14 in-vitro fertilization (IVF) and one gamete intra-Fallopian transfer (GIFT) cycles from 1990 to 1992. The Caucasian group consisted of 209 women scheduled for 213 IVF and 22 GIFT cycles during the same period. Buserelin, 500 micrograms subcutaneously daily, was started in the mid-luteal phase to achieve pituitary desensitization. Ovarian stimulation was with variable amounts of menopausal gonadotrophins. Human chorionic gonadotrophin (HCG) was given to trigger the ovulatory process. The Yoruba and Caucasian groups were similar in age and body weight, but significantly more Yorubas (45 versus 11%; P < 0.005) had ultrasound features of polycystic ovary syndrome (PCOS). The serum oestradiol concentration (3024 versus 2058 pg/ml; P < 0.05) and number of follicles > 14 mm in diameter (15.5 versus 9.5; P < 0.05) on the day of HCG were higher in the Yoruba group. The ovarian hyperstimulation syndrome (OHSS) was also more prevalent in the Yoruba group (20 versus 5%; P < 0.05). No difference was found in clinical pregnancy or embryo implantation rates. These results show a higher tendency toward exaggerated ovarian response in infertile Yoruba than Caucasian women, associated with a higher prevalence of PCOS. The risk of developing symptomatic OHSS is higher in Yoruba women.
来自尼日利亚西部的约鲁巴族育龄妇女自然受孕的多合子双胞胎和三胞胎妊娠发生率比高加索人高得多。本研究的目的是确定在辅助受孕的刺激周期中，不孕的约鲁巴族妇女和高加索族妇女在卵巢反应方面是否存在差异。1990年至1992年期间，共有11名约鲁巴族妇女安排进行了14次体外受精（IVF）和1次输卵管内配子移植（GIFT）周期。高加索组由209名妇女组成，同期安排了213次IVF和22次GIFT周期。在黄体中期开始每日皮下注射500微克布舍瑞林，以实现垂体脱敏。用不同剂量的绝经期促性腺激素进行卵巢刺激。给予人绒毛膜促性腺激素（HCG）触发排卵过程。约鲁巴族和高加索族组在年龄和体重方面相似，但有明显更多的约鲁巴族妇女（45%对11%；P<0.005）具有多囊卵巢综合征（PCOS）的超声特征。在注射HCG当天，约鲁巴族组的血清雌二醇浓度（3024对2058 pg/ml；P<0.05）和直径>14 mm的卵泡数量（15.5对9.5；P<0.05）更高。卵巢过度刺激综合征（OHSS）在约鲁巴族组中也更普遍（20%对5%；P<0.05）。在临床妊娠率或胚胎着床率方面未发现差异。这些结果表明，不孕的约鲁巴族妇女比高加索族妇女有更高的卵巢反应过度倾向，且与PCOS的更高患病率相关。约鲁巴族妇女发生有症状OHSS的风险更高。
