【摘要】 目的:回顾分析达英-35治疗后接受体外受精-胚胎移植(IVF-ET)的多囊卵巢综合征(PCOS)患者早期妊娠流产的内分泌因素及胚胎因素。方法:选择2003年1月～2007年9月因PCOS予达英-35预处理,且因输卵管因素在中山大学第一附属医院生殖医学中心接受IVF-ET辅助生殖后妊娠患者35例,其中早期流产15例,分娩20例。选择同期因单纯输卵管因素在本中心行IVF-ET的非PCOS早期流产患者20例为对照。对所有入组患者的基础代谢情况(BMI、空腹血糖、空腹胰岛素水平、HOMA-IR)、达英-35治疗前后及IVF-ET周期中的内分泌水平(启动日的FSH、LH、E2水平,及注射HCG日的LH、E2、P水平)、获卵数、受精率、优质胚胎率、胚胎种植率和废弃胚胎率等胚胎情况进行回顾性的统计学分析。结果:PCOS患者接受达英-35治疗后,LH、T水平均显著下降,且PCOS流产组LH水平及LH/FSH比值显著低于PCOS分娩组。PCOS流产组和PCOS分娩组患者的肥胖程度、代谢水平、基础内分泌水平及卵子、胚胎情况均无统计学差异。PCOS流产组与非PCOS流产组的内分泌及胚胎因素无统计学差异。结论:用达英-35预处理的P-COS患者接受IVF-ET后早期自然流产的发生与基础代谢、内分泌、卵子及胚胎情况无关。使用达英-35能降低PCOS患者的基础LH水平及基础T水平,但激素情况改善并非降低流产率的关键环节。更多还原

【Abstract】 Objective:To retrospectively analyse the endocrinological and embryonic factors of early pregnancy loss in patients with polycystic ovary syndrome(PCOS)after pretreatment on Diane-35 and IVF-ET cycles.Methods:Miscarried-PCOS group included 15 PCOS patients with tubal factors who miscarried after IVF-ET cycles.Delivered-PCOS group included 20 PCOS patients with tubal factors who delivered after IVF-ET cycles.These two groups of PCOS patients had received pretreatment of Diane-35 for 3 to 6 months before IVF cycles.The non-PCOS-miscarried group included patients with tubal factors only,who miscarried after IVF cycles.The sexual hormone levels were compared before and after treatment of Diane-35 between the miscarried-PCOS group and the delivered-PCOS group.The endocrinological levels,the metabolic conditions,the embryonic conditions and the pregnancy results were also compared among these three groups of patients.Results:After treatment of Diane-35 in miscarried-PCOS group and delivered-PCOS group,concentrations of total testosterone(T),luteinizing hormone(LH)and the LH/FSH ratio decreased significantly.The LH level and LH/FSH ratio were significantly lower in miscarried-PCOS patients than in delivered-PCOS patients.No significant differences were found in all the other comparisons.Conclusion:The basic endocrinological level,metabolic level,the condition of oocytes and embryos are similar among miscarried-PCOS patients,delivered-PCOS patients and miscarried-non-PCOS patients.The pretreatment of Diane-35 can significantly decrease the levels of LH and T,but the risk of early pregnancy loss is not decreased.更多还原