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目的比较未促排卵的未成熟卵母细胞体外培养成熟(IVM)治疗多囊卵巢综合征(PCOS)和正常月经周期伴不孕患者的临床疗效。方法回顾性分析2004年8月至2005年1月温州医学院第一医院收治的40例不孕患者,接受54个周期的IVM治疗,其中难治性PCOS不孕患者26例35个周期(A组),月经周期正常且经其它辅助生育技术失败的不孕患者14例19个周期(B组),均未采用任何药物刺激。结果共有7个周期取消,其中A组1个,取消率为2.8%;B组6个,取消率为31.6%,差异有极显著性意义(P<0.01)。有胚胎移植的47个周期中,两组的平均获卵数、体外成熟率、正常受精率和卵裂率、平均移植胚胎数差异无显著性意义(P>0.05)。A组1例生化妊娠,15例临床妊娠,B组4例临床妊娠。两组每穿刺周期的临床妊娠率(42.9%、21.1%)差异有极显著性意义(P<0.01),每移植周期的临床妊娠率、种植率和多胎率差异无显著性意义(P>0.05)。结论未促排卵的IVM技术治疗不孕症,尤其对于难治性PCOS不孕更是一种有效的方法。
Objective To compare the clinical efficacy of immature ovum immature oocytes (IVM) in the treatment of PCOS and normal menstrual cycles with infertility. Methods Forty infertile patients admitted to the First Hospital of Wenzhou Medical College from August 2004 to January 2005 were retrospectively analyzed. Fifty-four cycles of IVM were treated. Among them, 26 patients with refractory PCOS infertility had 35 cycles (A ), 14 infertile women with normal menstrual cycle and failed by other assisted reproductive techniques were given 19 cycles (group B), and no drug was used. Results A total of seven cycles were abolished, including 1 in group A with a cancellation rate of 2.8% and 6 in group B with a cancellation rate of 31.6%. The difference was significant (P <0.01). In 47 cycles of embryo transfer, the average number of oocytes retrieved, in vitro maturation rate, normal fertilization rate and cleavage rate, average number of embryos transferred had no significant difference (P> 0.05). A group of 1 case of biochemical pregnancy, 15 cases of clinical pregnancy, B group 4 cases of clinical pregnancy. The clinical pregnancy rate (42.9%, 21.1%) was significantly different between the two groups (P <0.01), and there was no significant difference in clinical pregnancy rate, implantation rate and multiple birth rate per transplant cycle (P> 0.05 ). Conclusion IVM without ovulation treatment of infertility, especially for refractory PCOS infertility is an effective method.