603例多囊卵巢综合征患者不同促排卵内膜准备方案对冻胚移植结局的影响

doi:10.6040/j.issn.1671-7554.0.2021.0050

摘要/Abstract

摘要： 目的比较冻融胚胎移植时不同促排卵用药方案对多囊卵巢综合征(PCOS)人群妊娠及母婴结局的影响。方法回顾性分析2017年2月至2020年5月于山东大学附属生殖医院进行冻胚移植且内膜准备方案为促排卵方案的PCOS患者共603个周期,根据不同的用药方案分为来曲唑组(n=30)、人绝经期促性腺激素(HMG)组(n=344)、来曲唑+HMG组(n=229),分别比较3组的活产率、临床妊娠率、胚胎植入率、流产率及母婴并发症的发生率。结果 3组间活产率、临床妊娠率、胚胎植入率、流产率及母婴并发症的发生率差异均无统计学意义(P>0.05);多因素Logistic回归分析在调整了体质量指数(BMI)、不孕年限、基础黄体生成素(LH)、基础总睾酮(To)及抗苗勒管激素(AMH)水平后,3组不同内膜准备方案的活产率、临床妊娠率和流产率差异均无统计学意义(P>0.05)。结论 3组不同的促排卵用药方案不会影响PCOS患者冻融胚胎移植后的结局,临床上应结合患者自身情况选择适合的促排卵用药方案。

关键词: 促排卵周期, 多囊卵巢综合征, 冻融胚胎移植, 内膜准备, 活产率

Abstract: Objective To compare the effects of different ovulation induction regimens on pregnancy and maternal and infant outcomes among women with polycystic ovary syndrome(PCOS)during frozen-thawed embryo transfer. Methods Totally 603 frozen-thawed embryo transfer cycles were analyzed by a retrospective study in PCOS population from February 2017 to May 2020. According to the different ovulation induction regimens, the patients were divided into 3 groups: the letrozole group(n=30), the human menopausal gonadotropin(HMG)group(n=344), and the letrozole plus HMG group(n=229). Meanwhile, live birth rate, clinical pregnancy rate, implantation rate, miscarriage rate, the incidence of maternal and infant complications were compared among three groups, respectively. Results There were no significant differences among groups in live birth rate, clinical pregnancy rate, implatation rate, miscarriage rate as well as the incidence of maternal and infant complications(P>0.05). Multivariate Logistic regression analysis also showed no significant differences in live birth rate, clinical pregnancy rate and miscarriage rate among the three groups after adjusting for body mass index(BMI), infertility years, luteinizing hormone(LH), testosterone(To)and anti-millertube hormone(AMH). Conclusion In PCOS patients, different ovulation induction regimens will not affect the pregnancy outcomes and the incidence of maternal and infant complications of frozen-thawed embryo transfer, and appropriate ovulation induction regimens should be selected based on patients conditions during clinical practice.

Key words: Ovulation induction, Polycystic ovary syndrome, Frozen-thawed embryo transfer, Endometrial preparation, Live birth rate

中图分类号:

R711.6

宫小舒,吴日超,李秀芳,潘烨,王泽,石玉华. 603例多囊卵巢综合征患者不同促排卵内膜准备方案对冻胚移植结局的影响[J]. 山东大学学报 (医学版), 2021, 59(3): 48-54.

GONG Xiaoshu, WU Richao, LI Xiufang, PAN Ye, WANG Ze, SHI Yuhua. Effect of different ovulation induction regimens for endometrial preparation on the outcome of frozen-thawed embryo transfer among 603 women with polycystic ovary syndrome[J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 48-54.

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