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目的:在高孕激素超促排卵(progestin-primed ovarian stimulation,PPOS)及全胚胎冷冻移植的背景下,探讨诱发排卵日内源性孕酮(P)水平与多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者体外受精/卵胞质内单精子显微注射(IVF/ICSI)临床结局的关系。方法:回顾性纳入180例PCOS患者行IVF/ICSI-冻融胚胎移植(FET)的资料,所有患者均采用促性腺激素(gonadtropin,Gn)联合孕激素的超促排卵方案,取卵后全部胚胎冷冻,择期行FET,根据诱发排卵日P水平分为A组(P<1.0μg/L,n=125)和B组(P≥1.0μg/L,n=55),比较两组患者的促排卵结局和妊娠结局。结果:A组与B组的Gn总用量(1950.8±384.5 IU vs 1931.2±308.9 IU)及周期治疗时间(11.2±1.4 d vs 11.1±1.1 d)均无统计学差异(P>0.05)。A组诱发日直径>14 mm卵泡数(14.1±7.7 vs21.0±10.3)、获卵数(14.0±7.8 vs 24.1±10.3)、成熟卵数(12.1±7.1 vs 21.1±9.0)、正常受精卵数(9.8±6.1 vs 16.8±8.2)及冷冻胚胎数(5.3±3.6 vs 7.2±3.4)均较B组低,且差异均具有统计学意义。成熟卵率、正常受精卵率、周期取消率、临床妊娠率及种植率组间均无统计学差异(P>0.05)。结论:在FET的前提下,高孕激素超促排卵过程中诱发日内源性P水平的升高提示卵巢反应良好,对PCOS患者的IVF/ICSI临床结局无明显影响。
OBJECTIVE: To investigate the relationship between endogenous progesterone (P) and polycystic ovary syndrome (IVC) induced ovulation on the background of progestin-primed ovarian stimulation (PPOS) PCOS) patients with in vitro fertilization / intracytoplasmic sperm injection (IVF / ICSI) clinical outcome. Methods: Data of IVF / ICSI-frozen-thawed embryo transfer (FET) were retrospectively retrospectively reviewed in 180 PCOS patients. All patients received gonadotrophin (Gn) Frozen, elective FET, according to the induced ovulation day P levels were divided into A group (P <1.0μg / L, n = 125) and B group (P≥1.0μg / L, n = 55) Ovulation outcomes and pregnancy outcomes. Results: The total amount of Gn in group A and B was no significant difference (1950.8 ± 384.5 IU vs 1931.2 ± 308.9 IU) and cycle treatment time (11.2 ± 1.4 days vs 11.1 ± 1.1 days) (P> 0.05). The number of oocytes (14.1 ± 7.7 vs 21.0 ± 10.3), the number of oocytes retrieved (14.0 ± 7.8 vs 24.1 ± 10.3), the number of mature eggs (12.1 ± 7.1 vs 21.1 ± 9.0), the number of normal fertilized eggs (9.8 ± 6.1 vs 16.8 ± 8.2) and frozen embryos (5.3 ± 3.6 vs 7.2 ± 3.4) were lower than those in group B, and the differences were statistically significant. No significant difference was found between mature egg rate, normal fertilized egg rate, cycle cancellation rate, clinical pregnancy rate and implantation rate (P> 0.05). Conclusion: The increase of endogenous P levels induced by hyperprolactin hyperoxidation under the premise of FET suggests a good ovarian response and no significant effect on IVF / ICSI clinical outcome in patients with PCOS.