Changes of Sex Hormone Levels in Infertile Population with Polycystic Ovary Syndrome after the Assisted Reproductive Technology Treatment
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摘要:
目的 探析不孕症人群中多囊卵巢综合征在接受辅助生殖技术治疗后的性激素水平变化，为治疗方案的选择提供依据。 方法 收集2016年1月至2021年6月期间于昆明医科大学第一附属医院就诊患者的病例资料，根据是否诊断为多囊卵巢综合征分为PCOS组（103名）和非PCOS组（589名），对比2组患者性激素变化情况。 结果 PCOS组的患者更为年轻，BMI更高，窦状卵泡数更多，AMH值更高，而Gn使用总量更低，PCOS组中LH/FSH > 2的人数多于非PCOS组（ P < 0.05）。经过治疗，2组的LH值均有所减少，FSH、E 2和P都呈上升趋势（P < 0.05）；且PCOS组LH和E 2治疗前后的差值均大于非PCOS组（P < 0.05）。 结论 相较于非PCOS不孕患者，PCOS不孕人群治疗前后的性激素指标变化更明显。为使多囊卵巢患者获得更好的临床疗效，建议在之后的治疗过程中关注相关性激素水平变化，合理选择治疗方案。 Abstract:Objective To investigate the changes of sex hormone levels in polycystic ovary syndrome（PCOS） in infertile population after the assisted reproductive technology treatment, and to provide an evidence for the choice of the treatment. Methods The medical data of patients admitted to the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2021 were collected and divided into PCOS group（103） and non-PCOS group（589） according to whether they were diagnosed with PCOS, and the sex hormone changes of the two groups were compared. Results The patients in PCOS group were younger and had the higher BMI, more sinus follicles, higher AMH value, and lower total Gn usage. The number of LH/FSH > 2 in PCOS group was higher than that in non-PCOS group（ P < 0.05）.After the treatment, LH in both groups decreased, FSH, E 2 and （P < 0.05） increased; The difference of LH and E 2 before and after the treatment in PCOS group was greater than that in non-PCOS group < 0.05）. Conclusion Compared with non-PCOS infertile patients, the changes of sex hormone indexes in PCOS infertile patients before and after the treatment were more obvious. In order to obtain the better clinical effect in patients with polycystic ovaries, it is recommended to pay attention to the changes of related sex hormone levels in the course of subsequent treatment, and choose a reasonable treatment plan. -
Key words:
- Polycystic ovary syndrome /
- Sex hormone /
- Treatment effect
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表 1 2组基本情况比较[（ $\bar x \pm s$）/ M（P25，P75）]
Table 1. Comparison of basic information between two groups[（ $\bar x \pm s$）/ M（P25，P75）]
项目 PCOS
（n=103）非PCOS
（n=589）t/Z P 年龄（岁） 28.32±4.10 33.98±5.93 −11.99 < 0.001 * BMI（kg/m2） 23.73±4.24 22.38±3.12 3.079 0.003* Gn总量（IU） 1650.0 （1387.0 ，2275.0 ）2337.5 （1650.0 ，3000.0 ）−5.347 < 0.001 * AMH（ng/ mL） 8.90（4.67，13.19） 2.42（1.15，4.45） −10.833 < 0.001 * 窦状卵泡数（个） 22.89±3.48 11.26±6.99 25.895 < 0.001 * LH/FSH 1.37（0.91，2.20） 0.85（0.54，1.36） −5.895 < 0.001 * *P < 0.05。 
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表 2 PCOS组性激素治疗前后对比[ M（P25，P75）]
Table 2. Comparison of sex hormone in PCOS group before and after treatment[ M（P25，P75）]
PCOS组 治疗前 治疗后 Z P FSH 5.78（5.09，7.01） 10.24（8.30，12.51） −8.173 < 0.001 * LH 9.02（5.77，13.13） 0.83（0.54，1.50） −8.411 < 0.001 * E2 45.19（34.23，55.70） 4035.0 （2581.80 ，5752.50 ）−8.419 < 0.001 * P 0.34（0.17，0.65） 0.825（0.57，1.30） −6.200 < 0.001 * *P < 0.05。
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表 3 非PCOS组性激素治疗前后对比[ M（P25，P75）]
Table 3. Comparison of sex hormone in non-PCOS group before and after treatment[ M（P25，P75）]
非PCOS组 治疗前 治疗后 Z P FSH 6.60（4.99，8.15） 15.68（12.37，21.18） −19.063 < 0.001 * LH 5.53（3.64，8.01） 1.620（0.86，3.53） −14.076 < 0.001 * E2 59.97（38.5，107.3） 2095.0 （1174.0 ，3706.5 ）−19.665 < 0.001 * P 0.37（0.20，0.65） 0.80（0.45，1.32） −9.014 < 0.001 * *P < 0.05。
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表 4 2组患者治疗前后性激素变化程度比较[ M（P25，P75）]
Table 4. Comparison of the changed levels of sex hormone before and after treatment between two groups[ M（P25，P75）]
项目 PCOS 非PCOS Z P FSH 4.96（2.313，6.96） 9.07（5.19，14.40） −7.583 < 0.001 * LH 8.00（3.80，12.65） 3.21（0.58，6.10） −7.014 < 0.001 * E2 3906.43 （2280.4 ，5177.7 ）1963.68 （1013.9 ，3520.8 ）−6.621 < 0.001 * P 0.40（0.16，0.90） 0.34（0.01，0.87） −1.320 0.187 *P < 0.05。
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