PCOS不孕患者手术后行体外受精-胚胎移植59例临床结局分析

Clinical analysis of 59 cases of ovarian surgery for infertile women with polycystic ovary syndrome in IVF treatment

目的探讨手术治疗后仍不孕的多囊卵巢综合征(PCOS)患者是否在以后的体外受精—胚胎移植(IVF-ET)治疗中妊娠率受到影响。方法回顾性分析2006年10月-2009年10月间我院生殖中心收治PCOS患者的IVF周期共143个,根据患者是否手术分为手术组与非手术组。行IVF-ET治疗,比较两组间临床和结局相关指标。结果手术治疗组共59个周期与非手术组84个周期相比,基础血黄体生成素(LH)、促卵泡生成素(FSH)、LH/FSH两组无统计学差异。手术组总睾酮(TT)值低于非手术组(164.44±19.78 nmol/l和202.93±21.28 nmol/l)。两组促性腺激素(Gn)用量、应用天数无统计学差异。全胚冷冻率、临床妊娠率、卵巢过度刺激综合征(OHSS)发生率两组比较均无统计学差异。手术组获卵数低于非手术组(15.24±9.13和18.82±7.88),有统计学差异;手术组优胚率高于非手术组(53.91%和42.34%),有统计学差异。结论手术治疗组的PCOS不孕患者行IVF治疗与非手术组相比,临床妊娠率并没有降低,优胚率相对更高。

Objective To analyze the clinical outcomes in IVF treatment of the infertile women with polycystic ovary syndrome（PCOS） after the ovarian surgery.Methods A retrospective analysis was performed on 143 IVF cycles which were carried out from October 2006 to September 2009 in our center.Patients were divided into the surgical group and non-surgical group.Clinical Indicators and outcomes were compared.Results Compared the 59 cases of the surgical group with the 84 cases of non-surgical group in IVF treatment,the levels of serum LH,FSH,LH/FSH radio were not statistically different.The surgical had higher serum TT than the non-surgical group（164.44±19.78 nmol/l vs.202.93±21.28 nmol/l）.The amps of gonadotropin and the duration of stimulation were not statistically different.Moreover,There was no significantly difference in all embryos crypreserved of total,clinical pregnancy rate and the incidence of ovarian hyperstimulation syndrome.In addition,the surgical group had lower oocytes collected（15.24±9.13 vs.18.82±7.88）,and higher good quality embryo（53.91% vs.42.34%）than the non-surgical group.Conclusion The clinical pregnancy rate of infertile women with polycystic ovary syndrome in IVF treatment after the ovarian surgery was no less than the non-surgical people.Otherwise,the the surgical group had higher good quality embryo than non-surgical group.