IVF周期中不同亚型多囊卵巢综合征不孕患者低剂量递增促排卵效果

Comparison of clinical results of low-dose increasing ovarian stimulation in IVF patients with different subtype of polycystic ovary syndrome

目的:分析不同亚型多囊卵巢综合征(PCOS)不孕患者在体外受精-胚胎移植(IVF-ET)治疗周期中,采用低剂量递增促排卵方案的临床治疗效果。方法:回顾性分析2006年5月至2010年4月按低剂量递增促排卵方案行IVF-ET治疗PCOS不孕患者共264周期,对患者按2003年鹿特丹标准分为3个亚型,Ⅰ型组86周期,Ⅱ型组157周期,Ⅲ型组21周期,比较各型实验室及临床相关指标的差异。结果:Ⅱ型组注射HCG日>14mm卵泡数(10.9±5.8)、可利用胚胎率(65.9%)低于Ⅰ型组(15.9±7.3;73.4%)和Ⅲ型组(14.0±7.2;77.4%),差异有统计学意义(F=17.351,P<0.001;χ2=19.471,P<0.001);余临床及实验室结果以及妊娠结局差异无统计学意义。结论:低剂量递增促排卵方案是PCOS不孕患者有效的促排卵方案之一,不同亚型的PCOS患者临床结局相似。

Aim：To compare clinical results of low-dose increasing ovarian stimulation in IVF patients with different subtype of polycystic ovary syndrome（PCOS）.Methods：The patients with PCOS（264 IVF-ET cycles） received low-dose increasing ovarian stimulation treatment in our center from May 2006 to April 2010 were retrospectively analyzed.Patients weredivided into 3 subtypes according to Rotterdam Standard 2003.There were 86 cycles in typeⅠgroup,157 cycles in type Ⅱ group,and 21 cycles in type Ⅲ group.The laboratorial and clinical indicators in each subgroup were compared respectively.Results：The number of follicles 〉14 mm of subgroupⅡ（10.9 ±5.8） at HCG day,and the rate of acquired embryos in subgroupⅡ（65.9%） was lower than those in subgroupⅠ（15.9 ± 7.3;73.4%） and subgroup Ⅲ（14.0 ± 7.2;77.4%）,and the differences were significant（F =17.351,P 〈 0.001;χ2 = 19.471,P 〈 0.001）.The other clinical results and experiment results had no significant difference.Conclusion：Low-dose increasing ovarian stimulation can be used as an effective protocol in infertility patients with PCOS,and the clinical results are similar to patients with different subtypes of PCOS.