PCOS不孕行IVF-ET新鲜周期移植的临床特点分析

目的 探讨采用体外受精-胚胎移植(IVF-ET)对多囊卵巢综合征(PCOS)不孕女性行助孕治疗并新鲜周期移植的特点和妊娠结局.方法 采用回顾性分析方法,选取2010年1月至2014年12月间因单纯PCOS不孕于第四军医大学唐都医院生殖医学中心进行IVF-ET治疗,长方案促排卵并新鲜周期移植的患者共406个周期(PCOS组);同期因单纯输卵管梗阻性不孕于第四军医大学唐都医院生殖医学中心进行IVF-ET治疗,长方案促排卵并新鲜周期移植的患者共2335个周期(对照组);比较两组的临床特征、妊娠结局及新生儿结局,并对结果进行统计.结果 PCOS组促性腺激素(Gn)时间(t=8.58)、人绒毛膜促性腺激素(hCG)日雌二醇(E2)水平(t=3.18)、周期取消移植率(χ2=34.28)、卵巢过度刺激综合征(OHSS)风险取消移植率(χ2=17.44)、卵裂率(χ2=2.71)、受精率(χ2=2.99)、自然流产率(χ2=8.15)、异位妊娠率(Fisher确切概率法P=0.00)、单胎足月新生儿体重(Fisher确切概率法P=0.00)均显著高于对照组,差异均有统计学意义(均P<0.05).PCOS组移植日子宫内膜厚度(t=-6.06)、种植率(χ2=62.74)、临床妊娠率(χ2=52.58)、单胎足月低体重儿比率(Fisher确切概率法P=0.03)均显著低于对照组,差异均有统计学意义(均P<0.05).PCOS组Gn总量、可用胚胎率、早产率、多胎率、巨大儿比率与对照组比较差异均无统计学意义(均P>0.05).结论 PCOS不孕症采用IVF-ET助孕治疗并新鲜周期移植较输卵管因素不孕症患者有更高的OHSS风险、不良妊娠结局及新生儿结局.

Clinical characteristics of infertility by polycystic ovary syndrome undergoing in vitro fertilization and fresh embryo transfer cycle

Objective To evaluate the characteristics and pregnancy outcomes of fresh embryo transfer cycle for infertile women with polycystic ovary syndrome(PCOS)treated by in vitro fertilization-embryo transfer(IVF-ET).Methods Using retrospective analysis, 406 cycles of single PCOS women treated with IVF-ET, using long stimulate ovulation and fresh cycle in the Assisted Reproduction Center of Tangdu Hospital during January 2010 to December 2014 were in PCOS group, and 2335 cycles of tubal factor infertile women with IVF-ET in the same period were in control group.Two groups were compared in clinical characteristics, pregnancy outcomes and neonatal outcomes,and the results were analyzed.Results Duration of gonadotropin hormone (Gn) application (t=8.58),estradiol (E2) level on human chorionic gonadotropin (hCG) day (t =3.18),cycle cancellation rate of transplant (χ2 =34.28),ovarian hyperstimulation syndrome (OHSS) risk cancellation rate of transplant (χ2 =17.44),cleavage rate (χ2 =2.71),fertilization rate (χ2 =2.99),spontaneous abortion rate (χ2 =8.15),ectopic pregnancy rate (P=0.00),singletons full-term newborn weight (P=0.00) were significantly higher than those in the control group, and the differences were statistically significant (all P<0.05).Endometrial thickness (t=-6.06), implantation rate (χ2 =62.74), pregnancy rate (χ2 =52.58),singletons full term low birth weight ratio (P=0.03) were significantly lower than those in the control group, and the differences were significant (all P<0.05).Total Gn,available rate of embryos,preterm birth rate,multiplets rate,ratio of macrosomia did not show remarkable differences between two groups (all P>0.05).Conclusion PCOS infertility with IVF-ET and fresh cycle transfer has a higher risk of OHSS, adverse pregnancy outcomes and poor neonatal outcomes than infertility of tubal factor.