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目的:对不同类型多囊卵巢综合征(PCOS)患者行体外受精-胚胎移植(IVF-ET)的妊娠结局进行分析,以了解其相互关系,并对PCOS不孕患者进行IVF-ET前的治疗提供参考和依据。方法:对2000年1月至2009年2月在中山大学附属第一医院生殖医学中心进行首个IVF-ET周期的无排卵或稀发排卵PCOS患者共576例进行回顾性分析。按患者进入周期前的临床特征分为4个组别。高雄激素组(高T组):高T的临床和(或)生化表现+双侧卵巢PCO样+稀发或无排卵,共85例;高黄体生成激素组(高LH组):LH/FSH>2+双侧卵巢PCO样+稀发或无排卵,共105例;高T+高LH组:高T的临床和(或)生化表现+LH/FSH>2+双侧卵巢PCO样+稀发或无排卵,共70例;对照组:仅符合双侧卵巢PCO样+稀发或无排卵,共316例。对4组患者的基本资料、IVF-ET周期的卵子和胚胎情况及妊娠结局进行回顾性比较。结果:4组患者的年龄、体重指数、不孕年限比较,差异无统计学意义(P>0.05);IVF周期中的获卵数、受精率、卵裂胚胎数和种植率比较,差异也无统计学意义(P>0.05);临床妊娠率对照组高于其他3组(P<0.05);早期流产率在4组中比较,差异无统计学意义(P>0.05);继续妊娠率对照组高于高T组和高T+高LH组(P<0.05),而高LH组与其他各组比较,差异无统计学意义(P>0.05)。结论:在接受IVF-ET的不同类型无排卵或稀发排卵的PCOS患者中,不合并高T和(或)高LH的患者妊娠结局最佳,高LH血症和高T均对妊娠结局产生不利影响。对PCOS不孕患者行IVF-ET前内分泌紊乱的正确评估及积极纠正可能有利于改善其妊娠结局。
OBJECTIVE: To analyze the pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) in patients with different types of polycystic ovary syndrome (PCOS) in order to understand the relationship between them and to treat pre-IVF-ET patients with PCOS infertility Provide reference and basis. Methods: A total of 576 cases of anovulatory or sparse ovulation PCOS were enrolled in the first cycle of IVF-ET from January 2000 to February 2009 in the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University for retrospective analysis. According to the clinical characteristics of patients before entering the cycle is divided into 4 groups. Holstein hormone group (high T group): high T clinical and (or) biochemical manifestations + bilateral ovarian PCO + sparse or no ovulation, a total of 85 cases; high luteinizing hormone group (high LH group): LH / FSH > 2+ Bilateral ovarian PCO + sparse or anovulatory, a total of 105 cases; high T + high LH group: high T clinical and (or) biochemical performance + LH / FSH> Or anovulation, a total of 70 cases; control group: only consistent with bilateral ovarian PCO + sparse or anovulatory, a total of 316 cases. The basic data of four groups of patients, IVF-ET cycles of eggs and embryos and pregnancy outcomes were retrospectively compared. Results: There was no significant difference in the age, body mass index and the duration of infertility between the four groups (P> 0.05). The number of oocytes in the IVF cycle, fertilization rate, embryo number and implantation rate were also different (P> 0.05). The clinical pregnancy rate was higher in the control group than in the other three groups (P <0.05). The rate of early miscarriage in the four groups was no significant difference (P> 0.05) (P <0.05), while there was no significant difference between high LH group and other groups (P> 0.05). CONCLUSIONS: Among patients with different types of IVF-ET with or without ovulation, those with no high T and / or high LH had the best pregnancy outcome, high LH and high T were associated with pregnancy outcome Negative Effects. Correct assessment and positive correction of pre-eclampsia of IVF-ET in patients with PCOS infertility may be beneficial to improve their pregnancy outcomes.