论文部分内容阅读
目的探讨腹腔镜卵巢打孔对多囊卵巢综合征(PCOS)患者体外受精(IVF)-胚胎移植结局的影响。方法回顾性分析行IVF治疗的213例PCOS患者临床资料,将患者按是否曾行腹腔镜卵巢打孔分为打孔组和非打孔组,同时选择因盆腔输卵管因素行IVF非PCOS的患者作为对照组,比较3组患者IVF的治疗结局。结果打孔组PCOS患者AFC、基础LH、LH/FSH较非打孔组显著降低(P<0.05),而基础FSH、T以及卵巢体积在打孔与非打孔组中差异无统计学意义(P>0.05)。在促排卵过程中,打孔组促性腺激素的使用总量[(1 923.80±733.64)IU]显著高于非打孔组[(1 679.10±589.18)IU](P<0.05)。3组患者获卵数及可利用胚胎数相当,打孔组临床妊娠率、持续妊娠率和种植率(58.49%、50.94%、36.21%)略高于非打孔组和对照组(55%、46.88%、34.38%和49.23%、42.31%、33.57%),但差异无统计学意义(P>0.05)。结论腹腔镜下卵巢打孔后患者的卵巢储备功能虽较非打孔PCOS患者低,但仍高于非PCOS患者。而对于打孔后未自然成功妊娠而行IVF助孕治疗的PCOS患者,打孔并不影响其妊娠成功率。
Objective To investigate the effect of laparoscopic ovarian perforation on in vitro fertilization (IVF) - embryo transfer in patients with polycystic ovary syndrome (PCOS). Methods The clinical data of 213 PCOS patients treated with IVF were retrospectively analyzed. The patients were divided into perforation group and non-perforation group according to whether laparoscopic ovarian perforation was performed or not. At the same time, patients with IVF non-PCOS due to pelvic fallopian tube were selected as Control group, the treatment outcome of IVF in 3 groups was compared. Results PCF patients in perforation group had significantly lower AFC, basal LH and LH / FSH than those in non-perforation group (P <0.05), while there was no significant difference in basal FSH, T and ovarian volume between perforation and non-perforation groups P> 0.05). During ovulation induction, the total amount of gonadotrophin used in perforation group [(1923.80 ± 733.64) IU] was significantly higher than that in non-perforation group [(1679.10 ± 589.18) IU] (P <0.05). The number of oocytes retrieved and the number of available embryos in the three groups were similar, and the clinical pregnancy rate, continuous pregnancy rate and implantation rate (58.49%, 50.94%, 36.21%) in the perforating group were slightly higher than those in the non-perforated group and the control group (55% 46.88%, 34.38% and 49.23%, 42.31%, 33.57% respectively), but the difference was not statistically significant (P> 0.05). Conclusions Ovarian reserve after laparoscopic ovarian drilling is lower than non-perforated PCOS but still higher than non-PCOS. However, for PCOS patients who underwent IVF assisted pregnancy after perforation did not naturally succeed in pregnancy, perforation did not affect the success rate of pregnancy.