体外受精-胚胎移植中口服避孕药预处理对超排卵和妊娠结局影响的研究

Effects of oral contraceptive pretreatment on controlled ovarian hyperstimulation and outcomes of IVF-ET

目的:研究体外受精-胚胎移植(IVF-ET)中多囊卵巢综合征(PCOS)患者在超促排卵周期前应用口服避孕药(OCP)预处理的效果。方法:回顾性分析85例行IVF-ET的PCOS患者,按周期前是否使用过OCP分为A组(OCP预处理组,53例)和B组(对照组,32例)。对入选患者的病历资料进行统计分析,评估OCP预处理对PCOS患者促排卵的效果、中重度卵巢过度刺激综合征(OHSS)的发生及助孕结果的影响。结果:OCP预处理能明显减少卵巢功能性囊肿形成(P<0.05),OCP预处理组的促性腺激素(Gn)用药天数和剂量均比对照组增加(P<0.01),而成熟卵率更高,中重度OHSS发生率低于对照组,但差异无显著性(P>0.05),两组获卵数、受精率、流产率、临床妊娠率等差异均无统计学意义。结论:OCP预处理能较好地控制PCOS患者促排卵的时间,卵泡发育同步性更高,但并不改变中重度OHSS的发生率,Gn天数与Gn剂量较对照组增加。

Objective： To investigate the effects of oral contraceptive pretreatment （OCP） in patients with polycystic ovarian syndrome （PCOS） undergoing controlled ovarian hyperstimulation for IVF-ET. Methods： We randomly divided 85 patients with P- COS undergoing IVF-ET into an OCP （ n = 53 ） and a control group （ n = 32）, the former received OCP, while the latter did not before the cycle. We retrospectively analyzed the data of the patients for the ovulation promoting effect of OCP and its influence on the inci- dence of ovarian hyperstimulation syndrome （OHSS） and outcomes of IVF-ET. Results ： Compared with the control group, OCP sig- nificantly reduced the formation of ovarian cyst （ P 〈 0.05 ）, remarkably increased the duration of gonadotropin stimulation and con- sumption （P 〈 0.01 ）, and markedly raised the percentage of mature ova （ 87.92% vs 92.85%, P 〈 0.05 ）. But no significant differ- ences were observed between the two groups in the incidences of moderate and severe OHSS, number of retrieved oocytes, and rates of fertilization, miscarriage and clinical pregnancy. Conclusion： OCP for patients with PCOS can help to control the time of ovarian stimulation, improve the synchronism of follicular development, and increase the duration of gonadotropin stimulation and consumption, but cannot change the incidences of moderate and severe OHSS.