多囊卵巢综合征年轻不孕患者体外受精-胚胎移植结局研究

Pregnancy outcomes of young patients with polycystic ovary syndrome after in vitro fertilization and embryo transfer

目的探讨对<35岁多囊卵巢综合征(PCOS)不孕患者行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)受孕后的结局。方法选取2007年10月至2010年8月间在中山大学附属第一医院生殖中心第一次行IVF的<35岁PCOS患者共68例,对照组为<35岁的第一次行IVF的输卵管性不孕患者共1164例。对两组患者的基本资料、IVF-ET周期的卵子和胚胎情况以及妊娠结局进行回顾性比较。结果 <35岁PCOS患者IVF周期中的临床妊娠率(30.9%vs.44.1%)、流产率(14.3%vs.12.9%)、多胎率(42.9%vs.38.4%)、早产率(22.2%vs.14.7%)、小于胎龄儿(9.5%vs.11.1%)以及大于胎龄儿(9.5%vs.3.1%),与对照组患者比较,差异无统计学意义(P>0.05),但其妊娠期糖尿病(14.3%vs.4.1%)以及妊娠期高血压疾病(4.0%vs.1.0%)的发生率高于对照组,差异有统计学意义(P<0.05)。结论 <35岁PCOS不孕患者行IVF-ET治疗后的妊娠期糖尿病、妊娠期高血压疾病的发生率增加。

Objective To investigate the pregnancy outcome women with age 〈35 years polycystic ovary syndrome （PCOS） compared with control groups after in vitro fertilization and embryo transfer （IVF-ET）. Methods Women with PCOS who underwent the first time of IVF between October 2007 and August 2010 were considered. A total of 68 PCOS patients and 1164 patients with tubal infertility were included, and reviewed focusing on the basal characteristics, IVF-ET outcomes, and pregnancy outcomes. Results The clinical pregnancy rate（30.9% vs. 44.1%）, miscarriage rate （14.3% vs. 12.9%）, multiple pregnancy rate （42.9% vs. 38.4%）, preterm delivery rate （22.2% vs. 14.7%）, small for gestational age （SGA） （9.5 %vs. 11.1%） infant and large for gestational age （LGA） infant （9.5% vs. 3.1%） rate were not different between two groups （P〉0.05）. On the other hand, the morbidity of gestational diabetes mellitus （GDM） （14.3% vs. 4.1%） and hypertensive disorder complicating pregnancy （HDCP） （4.0% vs. 1.0%） was significantly higher than those in control group （P〈0.05）. Conclusion Age 〈35 years PCOS patients after IVF-ET did not present various higher pregnancy complications, but they presented some worse pregnancy outcomes, especially in GDM and HDCP.