多囊卵巢综合征不孕患者体外受精-胚胎移植后的妊娠结局

摘要

目的 探讨多囊卵巢综合征(PCOS)不孕患者接受体外受精-胚胎移植(IVF-ET)助孕治疗后的妊娠结局.方法 回顾性分析2005年8月至2011年6月在中国医科大学附属盛京医院和沈阳二○四医院因PCOS不孕接受IVF-ET助孕治疗的单胎妊娠患者(PCOS组)200例(中国医科大学附属盛京医院89例,沈阳二○四医院111例),以单纯输卵管因素接受IVF-ET助孕治疗的单胎妊娠患者400例(中国医科大学附属盛京医院178例,沈阳二○四医院222例)为对照组,比较两组患者治疗周期的自然流产率、早产率、妊娠期糖尿病及妊娠期高血压疾病的发生率、剖宫产率、足月小于胎龄儿和足月大于胎龄儿发生率以及新生儿窒息、围产儿死亡或畸形的发生情况.结果 PCOS组流产率为26.0％ (52/200),明显高于对照组的10.2％(41/400),差异有统计学意义(P＜0.05).PCOS组妊娠期糖尿病发生率、妊娠期高血压疾病发生率、早产率、剖宫产率分别为23.6％(35/148)、16.2％(24/148)、17.6％ (26/148)、83.1％ (123/148),高于对照组的4.2％(15/359)、6.1％ (22/359)、7.8％(28/359)、73.8％(265/359),两组分别比较,差异均有统计学意义(P均＜0.05)；PCOS组足月小于胎龄儿、足月大于胎龄儿、新生儿窒息、围产儿死亡或畸形的发生率分别为2.7％ (4/148)、4.7％(7/148)、5.4％ (8/148)、0,对照组分别为1.4％(5/359)、2.2％ (8/359)、2.8％(10/359)、0,两组分别比较,差异均无统计学意义(P均＞0.05).结论 IVF-ET是PCOS不孕患者的有效治疗方法,但流产率、妊娠期糖尿病及妊娠期高血压疾病发生率、早产率及剖宫产率均显著升高.%Objective To investigate the pregnancy outcomes of in vitro fertilization (IVF) and embryo transfer (ET) in infertile women with polycystic ovarian syndrome (PCOS).Methods From August 2005 to June 2011,200 IVF-ET cycles performed in women with polycystic ovarian syndrome in Shengjing Hospital and Shenyang 204 Hospital were enrolled in this retrospective study,matched with 400 IVF-ET cycles in infertile women with fallopian tube factors as control group.The incidence of abortion,gestational diabetes mellitus (GDM),hypertensive disorders in pregnancy,preterm birth,small for gestational age infant(SGA),large for gestational age infant (LGA),neonatal asphyxia,neonatal death and deformity was compared between two groups.Results The incidence of spontaneous abortion was 26.0％ (52/200) in PCOS group,which was significantly higher than 10.2％ (41/400) in control group (P ＜ 0.05).The incidence of GDM,hypertensive disorders in pregnancy,preterm birth,cesarean section in PCOS group was 23.6％ (35/148),16.2％ (24/148),17.6％ (26/148),83.1％ (123/148),which were significantly higher than 4.2％ (15/359),6.1％ (22/359),7.8％ (28/359),73.8％ (265/359) in control group (P ＜0.05).The incidence of SGA,LGA,neonatal asphyxia,neonatal death and deformity did not show remarkable difference between two groups,which were 2.7％ (4/148),4.7％ (7/148),5.4％ (8/148),0 in PCOS group and 1.4％ (5/359),2.2％ (8/359),2.8％ (10/359),0 in control group (P ＞0.05).Conclusion IVF-ET is an effective treatment for infertile women with PCOS,however,the incidence of spontaneous aborcion,GDM,hypertensive disorders in pregnancy,preterm birth,cesarean section in PCOS patients was increased.