【摘要】 目的比较多囊卵巢综合征(PCOS)患者三种助孕方案的治疗效果。方法回顾性分析2010年1月至2011年5月在本院助孕的PCOS患者,按接受的助孕方式分为三组:A组(n=97),自然周期卵母细胞体外成熟培养(IVM);B组(n=33),降调节后短暂促性腺激素(Gn)刺激再IVM;C组(n=112),长方案降调节后常规体外受精-胚胎移植(IVF-ET)助孕。比较三种助孕方案治疗效果。结果 B组和C组临床妊娠率无显著统计学差异(58.1%vs.57.7%,P>0.05),但均显著高于A组(32.5%)(P<0.05)。hCG日内膜厚度分别为A组(6.1±1.8)mm,B组(8.8±2.3)mm和C组(11.6±2.5)mm,三组间比较均有统计学差异(P<0.05)。A组未使用Gn,B组Gn用量为(578.1±314.4)IU,费用为(2,029.6士1204.8)元,C组Gn用量(1,751.1±692.8)IU,费用(5,768.4±2,100.8)元,三组比较均有统计学差异(P<0.05)。A、B组无卵巢过度刺激综合征(OHSS)发生,C组重度OHSS发生率为4.5%。结论 IVM助孕可以避免OHSS发生,若降调节后短暂Gn刺激再IVM助孕,由于子宫内膜发育得到改善,可以获得与长方案相似的临床妊娠率,是PCOS患者的一个经济安全有效的助孕方式选择。更多还原

【Abstract】 Objective:To compare the effectiveness of three strategies of in in-vitro fertilization(IVF) for treatment of women with polycystic ovary syndrome(PCOS). Methods:The clinical data of 242 patients with PCOS in our hospital from 2010 January to 2011 May were analyzed retrospectively.The patients were divided into three groups:97 patients received in vitro maturation(IVM) in natural cycles(group A),33 patients received IVM after down regulation and shortly gonadotropin(Gn) stimulation(group B) and 112 patients received regular IVF after long-term protocol(group C). Results:The clinical pregnancy rate in group B(58.1%) and group C(57.7%) were significant higher than that in group A(32.5%)(P<0.05).The endometrial thickness on hCG day in group A,B and C was(6.1±1.8)mm,(8.8±2.3)mm and(11.6±2.5)mm respectively,which showed significant differences between any two groups.Patients in group A did not receive Gn injection.In group B,Gn dosage was(578.1±314.4)IU and overall cost for controlled ovary hyperstimulation(COH) was (2029.6±1204.8)RMB.In group C,Gn dosage was(1751.1±692.8) IU and overall cost was (5768.4±2100.8)RMB.There were significant differences between any two groups(P<0.05).None of the patients in group A and group B occurred ovarian hyper-stimulation syndrome(OHSS),the severe OHSS in group C was 4.5%. Conclusions:IVM after down regulation and short Gn stimulation is a safer and cost-effective protocol for treatment of patients with PCOS to prevent severe OHSS and improve pregnancy rate comparing to routine IVM.更多还原