卵母细胞体外成熟技术在多囊卵巢综合征不育妇女中的应用

The application of in vitro maturation in the infertile women with polycystic ovarian syndrome

目的评价未成熟卵母细胞体外成熟(IVM)技术对多囊卵巢综合征(PCOS)不育患者的治疗效果。方法对2004年1月至2005年8月PCOS不育患者在本中心行IVM或常规体外受精-胚胎移植(IVF-ET)、卵胞浆内单精子注射(ICSI)的周期作回顾性分析。分为无药物刺激的IVM观察组共48例、68个周期,与IVF/ICSI组39例、42个周期,比较两组的获卵数、受精率、卵裂率、种植率、临床妊娠率、流产率、卵巢过度刺激综合征(OHSS)及多胎发生率。结果IVM组与IVF/ICSI组比较,IVM组未采用卵泡刺激素(FSH),IVF/ICSI组FSH用量为(25±6.2)支;受精率分别为70.7%及63.9%(P<0.01);卵裂率分别为87.9%及99.4%(P<0.01);OHSS分别为0及7.1%(P<0.05),差异均具统计学意义。两组的获卵数、种植率、妊娠率、流产率、多胎率差异均无统计学意义(P>0.05)。结论IVM技术对难治性PCOS不育患者是一种较为节约,且不发生OHSS的有效辅助生育技术。

Objective： To evaluate the effects of in vitro maturation （IVM） in the infertile women with polycystic ovarian syndrome. Methods： The infertile women with PCOS who underwent IVM or IVF/ICSI from January 2004 to August 2005 were studied retrospectively. 68 unstimulated cycles （48 cases） underwent IVM as IVM group, 42 cycles （39 cases） underwent IVF/ICSI as control group. Main outcomes including the number of oocytes retrieval, the rates of fertilization, cleavage, implantation, pregnancy, miscarriage, ovarian hyperstimulation syndrome （OHSS） and multiple pregnancies were assessed. Results： No FSH was administered in IVM group, and the mean number of FSH used in control group was 25 4-6.2 ampoules. When compared with control group, women in IVM group had a significant increase in fertilization rate （70.7% vs. 63.9%） and decreases in cleavage rate （87.9% vs. 99. 4%） and ovarian hyperstimulation syndrome （0 vs. 7. 1%）. No significant differences between IVM group and control group were found in the number of oocytes obtained, implantation rate, clinical pregnancy rate, miscarriage rate and multiple pregnancy rate. Canclusion： Our results suggest that, for infertile PCOS women who ask for the assisted conception treatment, IVM is a more economical and less OHSS complication method than conventional IVF treatment.