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[克罗米芬抵抗性多囊卵巢综合征:促性腺激素治疗失败后作为替代方案的体外受精治疗]

[Clomiphene resistant PCO syndrome: IVF treatment as an alternative in failed gonadotropin treatment].

作者信息

Berg F D, Brucker C, Stützle R, Hinrichsen M J

机构信息

I. Frauenklinik, Universität München.

出版信息

Geburtshilfe Frauenheilkd. 1994 Sep;54(9):502-4. doi: 10.1055/s-2007-1022326.

Abstract

34 infertile patients with severe clomiphene-resistant polycystic ovary syndrome were treated with IVF/ET. Stimulation attempts with gonadotropins had resulted in multifollicular ovarian reactions, which did not allow standard ovulation induction using hCG due to the risk of multiple pregnancy. The resulting oocyte retrieval rates (87.4%/treatment cycle), embryo transfer rates (73.3%/oocyte retrieval) and pregnancy rates (24.2%/embryo transfer) approximately corresponded to the rates which are achieved in women with tubal failure using IVF/ET. Since strictly a maximum of 2 embryos was transferred, the occurrence of multiple pregnancies of higher degree could be avoided as opposed to standard gonadotropin therapy. The treatment so far only resulted in singleton pregnancies. The relatively high ovarian hyperstimulation rate (34.4%, primarily WHO stage I-II) could not be unequivocally lowered even by aspiration of all larger follicles.

摘要

34例患有严重克罗米芬抵抗性多囊卵巢综合征的不孕患者接受了体外受精/胚胎移植(IVF/ET)治疗。使用促性腺激素进行刺激尝试导致了多卵泡卵巢反应,由于多胎妊娠的风险,这使得无法使用人绒毛膜促性腺激素(hCG)进行标准的排卵诱导。由此产生的取卵率(87.4%/治疗周期)、胚胎移植率(73.3%/取卵)和妊娠率(24.2%/胚胎移植)大致与使用IVF/ET治疗输卵管性不孕的女性所达到的比率相当。由于严格限制最多移植2个胚胎,与标准促性腺激素治疗相反,可以避免更高程度的多胎妊娠发生。到目前为止,该治疗仅导致单胎妊娠。即使抽吸所有较大的卵泡,相对较高的卵巢过度刺激率(34.4%,主要为世界卫生组织I-II期)也无法明确降低。

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