生殖医学杂志

目的探讨游离睾酮指数(FAI)对多囊卵巢综合征(PCOS)不孕患者接受IVF-ET治疗妊娠结局的预测价值。方法回顾性分析2013年1~12月在我院生殖中心接受IVF-ET助孕治疗的PCOS患者138例的临床资料,根据FAI分为两组:A组94例,FAI<3.08;B组44例,FAI≥3.08。比较两组患者的一般资料、基础性激素水平、促排情况、妊娠结局及妊娠并发症发生情况等。结果两组患者的年龄、基础FSH、Gn用量(支)、Gn使用时间(d)、获卵数、卵裂率、OHSS发生率、生化妊娠率比较,差异无统计学意义(P>0.05)。两组间早期流产率、妊娠期糖尿病发生率及妊娠期高血压疾病发生率比较,差异亦无统计学意义(P>0.05),但B组(FAI≥3.08组)有上升趋势。B组的基础LH[(7.83±4.66)U/L]、空腹胰岛素(INS)[(9.25±6.18)mU/L]、抗苗勒管激素(AMH)[(7.81±3.55)ng/ml]、优质胚胎率(42.90%)及临床妊娠率(36.36%)与A组比较[分别为(5.98±3.19)U/L、(6.48±3.51)mU/L、(6.78±3.62)ng/ml、48.60%及55.32%],差异有统计学意义(P均<0.05)。结论 PCOS不孕患者行IVF-ET助孕治疗过程中血清FAI越低其妊娠结局可能越好。

Objective: To study the predictive value of free testosterone index on the pregnancy outcome in polycystic ovary syndrome(PCOS)women undergoing IVF.Methods: The data of 138 PCOS women undergone IVF treatment in our reproductive center from January 2013 to December 2013 were retrospectively analyzed.The patients were divided into two groups according to free testosterone index(FAI)value:group A with FAI value<3.08(n=94),and group B with FAI value≥3.08(n=44).The general condition,basic reproductive hormone levels,induced ovulation,IVF outcome,and pregnancy complications were compared between the two groups.Results: The patients' age,basal FSH,amount and duration of gonadotropin(Gn)used,number of oocytes retrieved,cleavage rate,incidence of ovarian hyperstimulation syndrome(OHSS),and biochemical pregnancy rate were not significantly different between the two groups(P>0.05).The early abortion rate,gestational diabetes incidence,and gestational hypertension incidence were slightly increased in the group B,but they were not significant different(P>0.05).The basic LH levels[(7.83±4.66)U/L vs.(5.98±3.19)U/L ],fasting insulin [(9.25±6.18)mU/L vs.(6.48±3.51)mU/L],anti-Mullerian hormone(AMH)[(7.81±3.55)ng/ml vs.(6.78±3.62)ng/ml],high quality embryos rate(42.90% vs.48.60%)and clinical pregnancy rate(36.36% vs.55.32%)in group B were significantly different with those in group A(P<0.05).Conclusions: The lower free testosterone index value may be a good predictor for a better pregnancy outcome in PCOS women undergoing IVF.