多囊卵巢综合征患者IVF⁃ET后流产情况分析
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R711.6

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南京鼓楼医院临床研究专项(2022-LCYJ-MS-35)


Analysis of miscarriage rates after IVF⁃ET in patients with polycystic ovary syndrome
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    摘要:

    目的:分析多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者与非PCOS患者行体外受精—胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕后临床结局相关指标差异,阐明PCOS不孕人群接受IVF-ET治疗后的流产风险。方法:回顾性分析2016年4月—2021年4月在南京大学医学院附属鼓楼医院生殖医学中心首次行IVF-ET助孕后实现临床单胎妊娠 PCOS 患者 655 例,并分析同期单纯输卵管因素不孕患者的临床资料,采用倾向性评分匹配(propensity score matching, PSM),根据年龄以及体重指数(body mass index,BMI)进行1∶1匹配,比较两组人群的相关助孕指标和流产率差异,并根据BMI 对纳入人群进行亚组分层分析。结果:与非PCOS组相比,PCOS组IVF周期需要更多的促性腺激素(gonadotropins,Gn)用量及更长的使用时间,人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)扳机日血清卵泡刺激素(follicle-stimulating hor- mone,FSH)、黄体生成素(luteinizing hormone,LH)及孕酮(progesterone,P)水平均低于非PCOS组(P<0.05)。而两组患者的早期及晚期流产率差异均无统计学意义(P>0.05)。根据不同BMI区间进行亚组分析,不同的BMI水平并未对患者流产率产生影响,两组患者流产率在各BMI亚组中相似,差异无统计学意义(P>0.05)。结论:对于首次接受IVF-ET辅助生殖治疗并获得单胎妊娠不孕患者而言,PCOS对其流产情况并无影响;对于首次接受IVF-ET助孕治疗的PCOS患者倾向进行新鲜同期单囊胚移植,可获得较为稳定的妊娠结局。

    Abstract:

    Objective:To retrospectively analyze the difference of clinical outcomes related indicators between patients with polycystic ovary syndrome(PCOS)and non -PCOS after assisted pregnancy by in vitro fertilization embryo transfer(IVF -ET),and to clarify the risk of miscarriage in the infertile population with PCOS after receiving IVF-ET treatment. Methods:A retrospective analysis was conducted on 655 PCOS patients with clinical single pregnancy after the first IVF-ET assisted pregnancy at the Reproductive Medical Center of Nanjing Drum Tower Hospital,affiliated with Nanjing University Medical College from April 2016 to April 2021.Clinical data of patients with infertility due to tubal factors during the same period were also analyzed. Propensity score matching(PSM)was used to performed a 1∶1 matching based on age and body mass index(BMI). The assisted reproduction outcomes and miscarriage rates were compared between the two groups,and a subgroup analysis based on BMI was conducted within the included population. Results:Compared to the non-PCOS group,the PCOS group required higer doses and a longer duration of gonadotropins Gn during IVF cycles. The levels of serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),and progesterone(P)on the day of human chorionic gonadotropin(hCG)trigger were lower than in the non-PCOS group(P < 0.05). However,there was no significant difference in early and late miscarriage rates between the two groups(P > 0.05). Subgroup analysis based on different BMI ranges showed that different BMI levels did not have an impact on the miscarriage rates of the patients. The miscarriage rates were similar in each BMI subgroup of the two groups,and the difference was not statistically significant(P > 0.05).Conclusion:PCOS has no effect on the miscarriage of patients who received IVF-ET assisted reproductive therapy for the first time and got single pregnancy infertility;PCOS patients who first received IVF-ET assisted pregnancy treatment tend to receive single blastocyst transfer,which can obtain a relatively stable pregnancy outcome.

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陆菲菲,黄晨阳,孙彦欣,邢俊.多囊卵巢综合征患者IVF⁃ET后流产情况分析[J].南京医科大学学报(自然科学版),2023,(12):1714-1718

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  • 收稿日期:2023-08-13
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  • 在线发布日期: 2023-12-12
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