摘要
目的分析促性腺激素释放激素激动剂(Gn RHa)长方案对行体外受精-胚胎移植(IVF-ET)的多囊卵巢综合征(PCOS)患者妊娠结局的影响。方法收集因PCOS不孕行IVF-ET治疗患者中用GnRHa长方案调节的719例患者,依据患者血清睾酮水平,将其分为两组:A组为高雄激素血症型PCOS患者(538例),B组为雄激素正常型PCOS患者(181例),比较两组患者一般情况(女方年龄、男方年龄、不孕年限、基础性激素水平、体质指数)、获卵移植情况(HCG日激素水平、获卵数、内膜厚度、移植第几天胚胎、移植胚胎数)及妊娠结局(妊娠率、单胎妊娠率、双胎及多妊娠率、活产率、流产率、早期流产率、晚期流产率及异位妊娠率)。结果两组相比,男女双方年龄、不孕年限、基础卵泡刺激素(bFSH)、HCG日黄体生成素(LH)、孕激素(P)、雌二醇(E_2)激素水平、活产率、早期和晚期流产率均差异无统计学意义(P>0.05),而基础雌二醇(bE_2)、基础黄体生成素(bLH)、体质指数、总妊娠率、单胎妊娠率、流产率A组高于B组(P<0.05),尤其是bLH、体质指数、总妊娠率A组显著高于B组(P<0.01),异位妊娠率、双胎及多胎妊娠率B组高于A组(P<0.05)。结论 GnRHa长方案可有效改善高雄激素血症型PCOS患者的内分泌紊乱情况,明显增加患者临床妊娠率,是较理想的用药方案,但同时患者的流产风险增加,妊娠中需多加注意。
Objective To compare in vitro fertilization and embryo transfer （IVF- ET） outcome between hy- perandrogenism polyeystic ovarian syndrome （PCOS） patients and no hyperandrogenism PCOS patients treated with go- nadotriopin - releasing hormone （GnRH） agonist long protocol. Methods Patients with PCOS, who underwent IVF - ET with GnRHa regulation in reproductive medical center of the third affiliated hospital of Guangzhou Medical University from 2011 to 2015, were enrolled and divided into two groups according to theirs serum testosterone, the hyperandrogenism P- COS group （ Group A, n =538 patients） and non - hyperandrogenism PCOS group （ Group B, n = 181 ）. We recorded and compared their general condition （women and men age, infertility duration, the basic hormone level, body mass index）, get - egg and embryo transfer situation （ the profile hormone level and eudometrial thickness on the day of HCG administra- tion, the number of oocytes, the day and the number of transferred embryos） and pregnancy outcome （ pregnancy rate, live birth rate, abortion rate and ectopic pregnancy rate）. Results There was no significant difference in women and men age, infertility duration, basic FSH, live birth rate, LH, P, E2 on the day of HCG administration, or abortion rates of ear- lier and later phase between the 2 groups （P 〉 0. 05）. The basic E2 and LH, BMI, endometrial thickness on the day of HCG administration, pregnancy rate, and abortion rate in Group A was significantly higher than those in Group B, but the ectopic pregnancy rate and multiple pregnancy rate in Group A was significantly lower than those in Group B （ P 〈 0. 05 ）. Conclusion GnRHa long protocol is the optimal choice for the hyperandrogenism PCOS patients, it can efficiently im- prove the metabolic disorders and increase the pregnancy rate of the patients, but miscarriage rate is also increased, so more concern is needed after IVF - ET.
出处
《广东医学》
CAS
2018年第1期103-106,共4页
Guangdong Medical Journal
基金
广东省生殖医学重点实验室建设项目(编号:粤科财字[2012]125号)
