[PCOS中基线LH/FSH比率对IVF-ET结果的影响:回顾性队列研究]
C Y Wang1, A H Wang1, J Y Wang1
1Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University, Hefei 230031, China.
Zhonghua fu chan ke za zhi
|August 26, 2024
概括
患有多囊性卵巢综合征 (PCOS) 和较高的黄素激素/卵泡刺激激素 (LH/FSH) 比率的女性面临卵巢过度刺激综合征和妊娠糖尿病的风险增加. 冷解胚胎移植为这些患者提供了更好的妊娠结果.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精中进行体外受精.
- 多囊性卵巢综合征 (PCOS) 是一种疾病.
背景情况:
- 黄素激素/卵泡刺激激素 (LH/FSH) 的比率是诊断多囊性卵巢综合征 (PCOS) 的关键指标.
- 了解基线LH/FSH比对体外受精-胚胎移植 (IVF-ET) 结果的影响,对于优化PCOS患者治疗策略至关重要.
研究的目的:
- 调查PCOS妇女的基线LH/FSH比率及其在体外受精-胚胎移植 (IVF-ET) 后的结果之间的关联.
- 为了比较PCOS患者之间的IVF-ET结果,基线LH/FSH比率高 (>2) 和基线LH/FSH比率低 (≤2) 的患者.
主要方法:
- 追溯队列研究涉及2868名接受IVF-ET的PCOS患者.
- 倾向性得分匹配 (1:2.5) 用于在基线比率高 (LH/FSH>2) 和低 (LH/FSH ≤2) 的组之间平衡基线特征.
- 控制卵巢刺激参数,卵细胞检索,胚胎发育和怀孕结果的比较,包括卵巢过度刺激综合征 (OHSS) 和妊娠糖尿病 (GDM) 的发病率.
主要成果:
- 患有较高LH/FSH比率的患者需要更低的淋巴激素 (Gn) 剂量和更短的刺激时间,但体外成熟率更高,获得的卵细胞和分裂期胚胎更多.
- 中度至重度的卵巢过度刺激综合征 (OHSS) 和妊娠期糖尿病 (GDM) 的发生率在高LH/FSH比率组显著更高.
- 与低比率组相比,高LH/FSH比率组的新鲜胚胎移植 (ET) 周期的临床怀孕和分娩率较低;然而,冷解ET周期的分娩率在高比率组中较高. 在高LH/FSH比率组中,新鲜ET循环的结果比冷解ET循环的结果差.
结论:
- 在PCOS患者中,较高的LH/FSH基线比率与控制卵巢刺激后中度至严重的OHSS和GDM风险增加有关.
- 冷解胚胎移植 (FET) 似乎是实现更好的妊娠结果在PCOS患者更高的基线LH/FSH比率更有效的策略.
- 这些发现强调了在为PCOS患者量身定制IVF-ET协议和转移策略时考虑基线LH/FSH比率的重要性.
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