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目的探讨在体外受精与胚胎移植(IVF-ET)助孕中多囊卵巢综合征(PCOS)女性的基础窦卵泡数(AFC)能否反映卵母细胞及胚胎质量。方法收纳2014年1月~2015年7月在中国人民解放军海军总医院生殖中心首次行IVF-ET助孕的PCOS患者(100名)和对照组患者(130名),观察所有研究对象的基础AFC、基本情况指标、控制性超促排卵(COH)情况,比较PCOS组与对照组的卵母细胞质量、胚胎质量及妊娠结局。结果 PCOS组的月经周期、BMI、基础AFC、基础双侧卵巢体积的平均值(OV)、基础LH、基础LH/FSH、基础T、基础ASD、Gn起始时AFC、获卵数、成熟卵母细胞数、2PN数、卵裂数、优质D3胚胎数均高于对照组(P<0.05)。PCOS组FSH较对照组低(P<0.05)。而两组成熟卵母细胞率、正常受精率、优质D3胚胎率及妊娠结局无差异。PCOS女性获卵数、成熟卵母细胞数级优质D3胚胎数随基础AFC的增多而呈线性递增,但其成熟卵母细胞所占比例、优质D3胚胎率不随基础AFC的变化而变化。结论在IVF-ET助孕中PCOS女性基础窦卵泡数不能反映其卵母细胞及胚胎质量。
Objective To investigate whether AFC in women with polycystic ovary syndrome (PCOS) during in vitro fertilization and embryo transfer (IVF-ET) can reflect the quality of oocytes and embryos. Methods A total of 100 patients with PCOS (130 patients) and control subjects (130 patients) undergoing first-aid IVF-ET in the Reproductive Center of the PLA Navy General Hospital from January 2014 to July 2015 were enrolled in this study. The basis of all subjects was AFC , Basic situation indicators and controlled ovarian hyperstimulation (COH). The oocyte quality, embryo quality and pregnancy outcome of PCOS group and control group were compared. Results PCOS group had significant differences in menstrual cycle, BMI, basal AFC, basic bilateral ovarian volume (OV), basal LH, basal LH / FSH, basal T, basal ASD, Gn initial AFC, number of oocytes retrieved, mature egg The numbers of blast cells, 2PNs, cleavage numbers and high quality D3 embryos were all higher than those of the control group (P <0.05). FSH in PCOS group was lower than that in control group (P <0.05). The two groups of mature oocyte rate, normal fertilization rate, high quality D3 embryo rate and pregnancy outcome no difference. The number of oocytes retrieved by PCOS and the number of high quality D3 embryos of several oocytes of mature oocytes increased linearly with the increase of basal AFC, but the proportion of mature oocytes and the rate of high quality D3 embryos did not change with the change of basal AFC. Conclusions The number of female basal antral follicles in women with PCOS can not reflect the quality of their oocytes and embryos in IVF-ET assisted pregnancy.