不同促排卵方案在多囊卵巢综合征患者未成熟卵母细胞体外成熟治疗中的疗效比较

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摘要目的：比较在未成熟卵母细胞体外成熟（IVM）技术中，多囊卵巢综合征（PCOS）患者2种促排卵方案的临床结局。方法：回顾性分析2005年1月至2015年12月于温州医科大学附属第一医院生殖医学中心行IVM治疗的PCOS患者的实验室结果及临床结局，共164个周期分2组，A组为黄体期长方案体外受精（IVF）改行IVM，共116个周期；B组为微刺激IVM周期，共48个周期。结果：A组促性腺激素（Gn）用量为（1 008.83± 579.68）IU显著高于B组的（540.52±329.16）IU，差异有统计学意义（P＜0.05）。A组的获卵数为（13.35±7.36）个，与B组获卵数（17.63±11.6）个比较，差异有统计学意义（P＜0.05）。2组的临床妊娠率（45.95% vs. 53.33%）及种植率（23.18% vs. 24.37%）比较，差异均无统计学意义（P＞0.05）。A组的流产率为8.11%，较B组20.00%低，差异有统计学意义（P＜0.05）。A组活产率为32.43%，与B组28.89%比较，差异无统计学意义（P＞0.05）。结论：PCOS患者行IVF改行IVM或微刺激IVM均可获得较好的临床妊娠率，IVF改行IVM可获得相对低流产率及高活产率，不失为一种有效的补充方法，可以降低周期取消率，增加患者的妊娠机会。

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	金聪聪
	王佩玉
	林佳
	吴燕虹
	周玮
	赵军招

关键词 ：多囊卵巢综合征, 体外成熟, 体外受精, 胚胎移植

Abstract：Objective: To compare the effectiveness of two clinical stimulated protocols in vitro maturation (IVM) cycles of polycystic ovary syndrome (PCOS) patients. Methods: Laboratory and clinical results were analyzed retrospectively for PCOS patients in IVM from January 2005 to December 2015 in the First Affiliated Hospital of Wenzhou Medical University. The overall 164 cycles were divided into two groups according to the stimulation protocol used, group A, IVM followed standard luteal long protocol (116 cycles) and group B, mild stimulated IVM (48 cycles). Basal characteristic, laboratory and clinical outcomes were used to assess the influence of different stimulated IVM in PCOS patients. Results: In the group A, the total dose of gonadotropin (1 008.83±579.68) IU was statistically higher than that in group B (540.52±329.16) IU (P<0.05). Numbers of oocytes retrieved of group A was significantly lower than that in group B (P<0.05). The group A also showed lower miscarriage rates compared to the other group (8.11% vs. 20.00%, P<0.05). The differences of embryo implantation rate (23.18% vs. 24.37%), clinical pregnant rate (45.95% vs. 53.33%) and live birth rate (32.43% vs. 28.89%) between the two groups were not statistically significant (P>0.05). Conclusion: PCOS patients using IVF convert in IVM cycles or gonadotropin priming IVM received the similar clinical pregnant rate compared with traditional IVF. However, the lower miscarriage rate of IVM converted from conventional stimulated IVF may lead to more clinical application.

Key words： polycystic ovary syndrome in vitro maturation in vitro fertilization embryo transfer

收稿日期: 2016-07-07

通讯作者: 赵军招，主任医师，Email：z.joyce08@163.com

作者简介: 金聪聪（1985-），女，浙江永嘉人，住院医师，硕士

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I6/441

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