Successive and cyclic oral contraceptive pill pretreatment improves IVF/ICSI outcomes of PCOS patients and ameliorates hyperandrogenism and antral follicle excess
Successive and cyclic oral contraceptive pill pretreatment improves IVF/ICSI outcomes of PCOS patients and ameliorates hyperandrogenism and antral follicle excess
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连续和周期性口服避孕药预处理可改善 PCOS 患者的 IVF/ICSI 结局，并改善雄激素过多症和窦卵泡过多
DOI：
10.3109/09513590.2014.995621
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发表时间：
2015-04-01
影响因子：
2
通讯作者：
Huang, He-Feng
中科院分区：
文献类型：
--
作者：
Pan, Jie-Xue;Liu, Ye;Huang, He-Feng
摘要目标：探讨口服避孕药（OCP）预处理对多囊卵巢综合征（PCOS）患者体外受精（IVF）/卵胞浆内单精子注射（ICSI）的影响。方法：回顾性分析500例PCOS患者和565例正常排卵患者行IVF/ICSI的临床资料。根据OCP预处理方案将PCOS患者分为3组：非OCP组（未经OCP预处理）、非连续OCP组（连续预处理时间≤2个月）和连续OCP组（连续预处理时间≥3个月）。在IVF预处理前/后进行全面的激素和超声评估。对影响妊娠结局的混杂因素进行Logistic回归分析。结果：PCOS患者存在明显的内分泌紊乱，种植率和妊娠率降低，流产率增加。连续而非不连续的OCP预处理可显著提高种植率和妊娠率，降低单胎小于胎龄儿的发生率，并伴有高雄激素血症和窦卵泡明显减少。结论：多囊卵巢综合征是IVF结局不佳的独立危险因素。连续而非间断的OCP周期性预处理可改善PCOS患者的妊娠结局，并减少高雄激素血症和窦卵泡过多。
Abstract Objectives: To evaluate different oral contraceptive pill (OCP) pretreatment associated differential in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes of polycystic ovary syndrome (PCOS) patients and explore enhanced hormonal balance induced by the pretreatment. Methods: This retrospective study included 500 PCOS women and 565 normal ovulating counterparts undergoing IVF/ICSI. The PCOS patients were divided into three groups based on the OCP pretreatment regimens: non-OCP (without OCP pretreatment), unsuccessive OCP (the period of successive pretreatment ≤2 months) and successive OCP (the period of successive pretreatment ≥3 months) groups. Comprehensive hormonal and ultra-sonographic assessments were performed before/after IVF pretreatment. Confounding factors affecting pregnancy outcomes were analyzed with logistic regression. Results: PCOS patients with significant endocrine disorders had reduced implantation and pregnancy rates and increased miscarriage rate. Successive, not unsuccessive OCP pretreatment, significantly improved the implantation and pregnancy rates, and reduced the incidence of monotocous small-for-gestational age infants, which was accompanied by remarkably decreased hyperandrogenism and antral follicles. Conclusion: PCOS is an independent risk factor for poor IVF outcome. Successive, not unsuccessive, OCP cyclical pretreatment could improve pregnancy outcome of PCOS patients, associated with reduction of hyperandrogenism and antral follicle excess.