Page 98 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第43卷第12期
·1714 · Journal of Nanjing Medical University（Natural Sciences） 2023年12月

·临床研究·

多囊卵巢综合征患者IVF⁃ET后流产情况分析

陆菲菲，黄晨阳，孙彦欣，邢 俊 *
南京大学医学院附属鼓楼医院生殖医学和妇产医学中心，南京大学分子生殖医学中心，江苏 南京 210008

［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。
［关键词］ 体外受精—胚胎移植；多囊卵巢综合征；单胎妊娠；流产
［中图分类号］ R711.6 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）12⁃1714⁃05
doi：10.7655/NYDXBNS20231215

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

LU Feifei，HUANG Chenyang，SUN Yanxin，XING Jun *
Center for Reproductive Medicine and Obstetrics and Gynecology，Nanjing Drum Tower Hospital，Nanjing University
Medical School，Center for Molecular Reproductive Medicine，Nanjing University，Nanjing 210008，China

［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）.

［基金项目］ 南京鼓楼医院临床研究专项（2022⁃LCYJ⁃MS⁃35）
∗
通信作者（Corresponding author），E⁃mail：Xing.jun@msn.com