CAJ | 학술논문

目的探讨体外受精-胚胎移植(IVF-ET)后多囊卵巢综合征(PCOS)患者的妊娠结局及其影响因素.方法选择IVF-ET治疗并成功单胎妊娠的患者189例,按照2003年ESHRE/ASRM鹿特丹诊断标准产生的PCOS不同表型分四组:规律排卵组、非高雄激素血症组、非PCOS组、经典PCOS组,比较各组妊娠结局的差异并分析原因.结果 4组年龄、体质量指数(BMI)、妊娠期糖尿病(GDM)、早产、胎儿出生体质量、畸形死胎率差异均无统计学意义(P均＞0.05),流产率及妊娠期高血压疾病(PIH)差异均有统计学意义(x2值分别为4.768、8.338,P均＜0.05).进一步两两比较发现,非高雄激素组流产率(14.29％与29.09％、39.53％、35.71％；P均＜0.05)和PIH(1.82％与17.14％、16.28％、17.86％:P均＜0.05)的发生均显著低于其他各组.结论不同的表型PCOS患者卵巢功能状态不同,体内内分泌环境有差异,可导致不同的妊娠结局,而PCOS妊娠后高胰岛素和雄激素血症及妊娠后期加重的胰岛素抵抗的相互作用是PCOS患者复杂妊娠结局产生的重要原因.
목적 탐토체외수정-배태이식(IVF-ET)후다낭란소종합정(PCOS)환자적임신결국급기영향인소.방법 선택IVF-ET치료병성공단태임신적환자189례,안조2003년ESHRE/ASRM록특단진단표준산생적PCOS불동표형분사조:규률배란조、비고웅격소혈증조、비PCOS조、경전PCOS조,비교각조임신결국적차이병분석원인.결과 4조년령、체질량지수(BMI)、임신기당뇨병(GDM)、조산、태인출생체질량、기형사태솔차이균무통계학의의(P균＞0.05),유산솔급임신기고혈압질병(PIH)차이균유통계학의의(x2치분별위4.768、8.338,P균＜0.05).진일보량량비교발현,비고웅격소조유산솔(14.29％여29.09％、39.53％、35.71％；P균＜0.05)화PIH(1.82％여17.14％、16.28％、17.86％:P균＜0.05)적발생균현저저우기타각조.결론 불동적표형PCOS환자란소공능상태불동,체내내분비배경유차이,가도치불동적임신결국,이PCOS임신후고이도소화웅격소혈증급임신후기가중적이도소저항적상호작용시PCOS환자복잡임신결국산생적중요원인.
Objective To investigate the pregnancy outcome and its influencing factors in patients with polycystic ovary syndrome (PCOS) after in vitro fertilization and embryo transfer (IVF-ET).Methods One hundred and eighty-nine cases of patients with single pregnancy after successful IVF-ET were selected as our subjects according to the 2003 ESHRE/ASRM Rotterdam diagnostic criteria.They were divided into four groups in accordance with PCOS phenotype:the group of regular ovulation,non hyper androgens group,non-PCO group,classic PCOS group.Differences pregnancy outcomes were recorded.Results There were no significant differences among four groups in terms of age,body mass index (BMI),Gestational diabetes mellitus (GDM),preterm delivery,fetal birth weight,malformations stillbirth (all P ＞ 0.05).The abortion rate and pregnancy induced hypertension(PIH) showed significant differences (x2 =4.768,8.338,P ＜ 0.05).A further two two comparison,in non Kaohsiung hormone group,the abortion rate(14.29％ and 29.09％,39.53％,35.71％ ; P ＜0.05) and PIH (1.82％ and 17.14％,16.28 ％,17.86％ ; P ＜ 0.05) were significantly lower than those in the other groups occurred.Conclusion Different phenotypes of PCOS patients had different ovarian function status.Endocrine environment difference might lead to a different outcome of pregnancy.The interaction of insulin resistance in patients with PCOS with high insulin,androgen hyperlipidemia,insulin resistance in late pregnancy played important roles in pregnancy outcomes.