目的探讨未刺激的未成熟卵体外培养成熟(IVM)治疗难治性多囊卵巢综合征(PCOS)不孕的疗效。方法2004-08-2005-08温州医学院附属第一医院生殖中心对56例难治性PCOS不孕患者进行78个周期的IVM治疗。结果9个周期取消,取消率为11.5%;69个移植周期共获卵1338个,平均每周期19.4个,培养48h后总成熟率为68.5%。正常受精率为70.2%,卵裂率为91.1%。移植日的子宫内膜厚度平均8.7mm,平均移植3.7个胚胎。1例异位妊娠,2例生化妊娠,28例获临床妊娠。每穿刺周期和移植周期的临床妊娠率分别为37.3%(28/75)和40.6%(28/69)。28例临床妊娠中,3例孕8~12周流产,1例孕22周因胎膜早破流产,15例已分娩,2例双胎和7例单胎在妊娠中。多胎妊娠率为39.3%(11/28)。结论未经刺激的IVM技术用于治疗难治性PCOS不孕是一种有效的方法,具有简单、经济、最低损伤且可获得与常规体外受精-胚胎移植(IVF-ET)相近的临床妊娠率,但多胎妊娠的发生率仍较高。 Objective To investigate the curative effect of unstimulated immature ovum in vitro fertilization (IVM) treatment of refractory polycystic ovary syndrome (PCOS) infertility. Methods A total of 56 cycles of IVM treatment of 56 patients with refractory PCOS infertility were enrolled in the Reproductive Center of the First Affiliated Hospital of Wenzhou Medical College from August 2004 to August 2005. Results Nine cycles were canceled with a cancellation rate of 11.5%. A total of 1338 eggs were obtained in 69 transplant cycles, with an average of 19.4 cycles per week. The total maturation rate was 68.5% after 48 hours of culture. Normal fertilization rate was 70.2%, cleavage rate was 91.1%. Endometrial thickness on transplant days averaged 8.7 mm and averaged 3.7 embryos. 1 case of ectopic pregnancy, 2 cases of biochemical pregnancy, 28 cases of clinical pregnancy. The clinical pregnancy rates per puncture cycle and transplant cycle were 37.3% (28/75) and 40.6% (28/69), respectively. Of the 28 clinical pregnancies, 3 had 8 to 12 weeks of pregnancy with abortion, 1 had 22 weeks of premature rupture of membranes, 15 had given birth, 2 had twin births, and 7 had single births during pregnancy. The multiple pregnancy rate was 39.3% (11/28). Conclusions The unstimulated IVM technique is an effective method for the treatment of refractory PCOS infertility with simple, economical, minimally invasive and achievable clinical pregnancy rates similar to conventional in vitro fertilization-embryo transfer (IVF-ET) , But the incidence of multiple pregnancies is still high.