多囊卵巢综合征患者卵泡输出率与临床结局的相关性

Association between follicular output rate and clinical outcome in patients with polycystic ovarian syndrome

目的探讨多囊卵巢综合征(PCOS)患者卵泡输出率与其临床结局的相关性。方法将285例首次接受体外受精-胚胎移植(IVF-ET)治疗的PCOS患者纳为研究对象,标准长方案促排卵,适时取卵、胚胎体外培养并移植。回顾性研究了各患者一般情况、控制性超排卵数据及实验室指标。结果 285例患者按FORT值分成高中低3组。3组患者年龄、不孕年限、体质指数、基础FSH、基础E_2值、AFC值、平均Gn量、Gn天数、移植胚胎数差异均无统计学意义,HCG日血E_2水平、成熟卵泡数(PFC)、获卵数、优胚率、移植周期临床妊娠率在高中低FORT 3组中依次降低,差异有统计学意义。高中低FORT各组患者中重度OHSS发生率分别是20.6%、9%、17.8%,差异有统计学意义(P=0.037)。结论 FORT值可预测PCOS患者的IVF临床结局。对于超排卵时FORT值较高或较低的PCOS患者应警惕OHSS发生,可行相应的预防措施。

Objective To find the association between follicular output rate and clinical outcome in patients with polycystic ovarian syndrome （PCOS）. Methods A total of 285 female patients with PCOS who were undergoing in vitro fertilization-embryo transfer （IVF-ET） for the first time were included in the study and were divided into three groups according to follicular output rate （FORT） values. The general information, the parameters of the controlled ovarian hyperstimulation, and clinical outcomes were compared. Results The concentration of serum E2 on the day of HCG, preovulatory follicle count （PFC）, the number of retrieved oocytes, good-quality em- bryo rates, clinical pregnancy rate decreased sequently in groups with high, mediate and low FORT value. The incidence of moderate and severe ovarian hyper-stimulation syndrome （OHSS） in the group with mediate FORT value was significantly lower than that of groups with high and low FORT value. The incidence of severe OHSS in 3 groups with high, mediate and low FORT value was 20.6%, 9% and 17.8% respectively and the difference was statistically significant （P = 0.037 ）. Conclusions The value of FORT nlay predict the clinical outcome of IVF/ ICSI-ET in patients with PCOS. Effort should be made to prevent OHSS in PCOS patients with high or low FORT value in their controlled ovarian hyperstimulation cycles.