【摘要】 目的 比较体外受精-胚胎移植（IVF-ET）治疗多囊卵巢综合征（PCOS）不孕患者拮抗剂(GnRH-ant与高孕激素状态下促排卵（PPOS）方案的治疗效果。方法 回顾性分析2019年1月至2022年3月于首都医科大学附属北京妇产医院生殖中心行IVF治疗的PCOS不孕患者。根据促排卵方案分为两组：拮抗剂方案组（260周期）和PPOS方案组（40周期）。统计分析两组患者基本情况、促排卵情况及胚胎实验室指标，同时分析相同促排卵方案下采用不同不扳机药物对IVF结局的影响。结果 两组患者基本情况指标均无显著性差异（P>0.05）;PPOS组HCG日E₂水平、PPOS组受精率、发育率显著高于拮抗剂组（P<0.05）；拮抗剂组重度卵巢过度刺激综合征（OHSS）发生率高于PPOS组，但二者差异无统计学意义（P>0.05）。此外，当采用拮抗剂方案，使用重组HCG为扳机时优质胚胎率显著高于双板机组和GnRH-a组，但其获卵数显著低于双板机组和GnRH-a组（P<0.05）。当采用PPOS方案，使用重组HCG为扳机药物时的优质胚胎率显著高于双板机组和GnRH-a组。结论 PPOS方案能够获得与拮抗剂方案相似的IVF-ET治疗结局，与拮抗剂方案相比，PPOS方案有较高的受精率和发育率，且可进一步降低重度OHSS发生风险，可作为PCOS患者促排卵方案的选择之一。当PCOS患者采用拮抗剂或PPOS促排卵方案时，选用重组HCG作为扳机时优质胚胎率高于双扳机和GnRH-a扳机。更多还原

【Abstract】 Objective To compare the treatment effect in vitro fertilization and embryo transfer（IVF-ET） between GnRH-ant and progestin primed ovarian stimulation（PPOS） of polycystic ovary syndrome（PCOS） infertility patients.Methods A retrospective analysis of PCOS infertile patients who underwent IVF treatment in the reproductive medicine department of Beijing Obstetrics and Gynecology Hospital from January 2019 to March 2022. They were divided into two groups based on the ovulation induction program: The antagonist regimen group（260 cycles） and the PPOS regimen group（40cycles）. We statistically analyzed the basic conditions, ovulation induction and embryo laboratory indicators of the two groups of patients as well as the effects of different trigger drugs in IVF-ET under the same ovulation induction protocol. Results There were no significant differences in basic conditions between the two groups of patients（P>0.05）. On HCG day, E₂ level, fertilization rate and embryo development rate of PPOS group were significantly higher than the antagonist group（P<0.05）, and the incidence of severe ovarian hyperstimulation syndrome（OHSS） in the antagonist group was higher than that in the PPOS group, but there was no statistical difference（P>0.05）. In the GnRH-ant group, the high-quality embryos rate was significantly higher of r-HCG than that of the dual trigger and GnRH-a group, but the number of eggs retrieved was significantly lower the dual trigger group and the GnRH-a group（P<0.05）. In the PPOS group, the high-quality embryo rate which in the r-HCG group was significantly higher than that in the dual trigger group and the GnRH-a group. Conclusion PPOS can obtain similar IVF-ET treatment outcomes as the GnRH-ant, and the PPOS has higher fertilization rates compared with the GnRH-ant. At the same time, PPOS can further reduce the risk of severe OHSS, which can be used as one of the effective COH options for PCOS patients. When PCOS patients use GnRH-ant or PPOS ovulation induction, the rate of high-quality embryos is higher when r-HCG is used as the trigger drug compare to dual trigger and GnRH-a trigger.更多还原