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目的 探讨卵泡期长方案和拮抗剂方案对超重多囊卵巢综合征(PCOS)患者IVF/ICSI周期鲜胚移植妊娠结局的影响。方法 回顾性分析2019年1月至2022年12月于武汉大学人民医院生殖医学中心行IVF/ICSI-ET助孕的175例超重(24 kg/m2≤BMI<28 kg/m2)PCOS患者(共175个周期)的临床资料，根据促排卵方案不同分为拮抗剂方案组(拮抗剂组，n=92)和卵泡期长方案组(长方案组，n=83),比较两组患者的促排卵情况和鲜胚移植结局。结果 两组患者间年龄、基础性激素和抗苗勒管激素(AMH)水平均无显著性差异(P>0.05);拮抗剂组的体质量指数(BMI)和基础窦卵泡数(AFC)显著高于长方案组(P<0.05)。拮抗剂组扳机日激素(LH、E2、P)水平、成熟卵母细胞率均显著高于长方案组(P<0.05),两组间优质胚胎率无显著差异(P>0.05)。两组患者中重度卵巢过度刺激综合征(OHSS)发生率、鲜胚移植妊娠结局均无显著性差异(P>0.05),长方案组的周期取消率显著低于拮抗剂组(36.1%vs. 64.1%,P<0.001),但拮抗剂组因预防OHSS的周期取消率显著低于长方案组(55.9%vs. 90.0%,P<0.05)。结论 对于超重PCOS患者，卵泡期长方案与拮抗剂方案的鲜胚移植周期妊娠结局无明显差异。卵泡期长方案周期取消率更低，具有更高的鲜胚移植机会；而拮抗剂方案OHSS发生风险更低，对于AFC较多的PCOS患者来说，该方案可能更为安全。
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基本信息:
中图分类号:R711.75;R714.8
引用信息:
[1]何一,赵聪颖,吴庚香.超重多囊卵巢综合征患者不同促排卵方案对鲜胚移植周期妊娠结局的影响[J].生殖医学杂志,2023,32(11):1744-1749.
基金信息:
武汉大学教学研究项目(2020JG073);武汉大学医学部教学研究项目(2021012)
2023-11-15
2023-11-15