پیامدها و معضلات همراه با لقاح داخل آزمایشگاهی در زنان مبتلا به سندرم تخمدان پلی‌کیستیک: یک مطالعه مروری

سوری نژاد, حدیث; صوابی اصفهانی, میترا; طراحی, محمد جواد; ادیب مقدم, الهام

نوع مقاله : مروری

نویسندگان

¹ دانشجوی دکترای تخصصی بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

² استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

³ دانشیار گروه اپیدمیولوژی و آمار زیستی، مرکز تحقیقات علوم رفتاری، دانشکده بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

⁴ استادیار، دکتری تخصصی بهداشت باروری، گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی گلستان، گلستان، ایران

چکیده

زمینه و هدف: سندرم تخمدان پلی‌کیستیک (PCOS)شایع‌ترین اختلال اندوکرینی زنان در سنین باروری می‌باشد. در زمینه کیفیت تخمک در این افراد و پیامدهای بارداری، دشواری‌های بسیاری وجود دارد؛ از این رو مطالعه مروری حاضر با هدف بررسی پیامدها و معضلات همراه با لقاح داخل آزمایشگاهی در زنان مبتلا به سندرم تخمدان پلی‌کیستیکصورت گرفت.
مواد و روش‌ها: برای یافتن مطالعات مرتبط، در بازه زمانی 1990 تا 2019 از پایگاه‌های فارسی SID و Magiran، پایگاه‌های اطلاعاتی انگلیسی Pubmed ،Scopus ،Elsevier ، Weily online library، Sciences Web Ofو موتور جستجویGoogle Scholar استفاده شد. برای دستیابی به تمام مقالات فارسی و انگلیسی موردنظر، از کلیدواژه‌های
Polycystic ovarian syndrome In vitro fertilization,،Polycystic ovarian morphology، IVF outcome ،Oocyte donation , Oocyte competence, Pregnancy, و معادل فارسی آنها به‌صورت مجزا یا ترکیبات احتمالی استفاده شد. از بین 450 مقاله، 17 مقاله واجد شرایط پژوهش بود و برای این مطالعه انتخاب شد.
یافته‌ها: معضلات عمده مطرح در این زنان، شامل نیاز به گنادوتروپین‌ها و تغییرات مربوط به سطوح هورمون‌ها، سندرم تحریک بیش از حد تخمدان (OHSS)، میزان بارداری بالینی، پیامدهای بارداری و خطر سقط جنین، کیفیت تخمک زنان PCOS تحت لقاح داخل آزمایشگاهی و مسئله اهدای تخمک می‌باشد. با این وجود، از دست رفتن جنین، میزان بارداری بالینی و میزان تولد زنده معمولاً نسبت به سایر زنان، متفاوت نمی‌باشد.
نتیجه‌گیری: با توجه به نگرانی‌هایی که در زمینه بارداری زنان PCOS وجود دارد، نظارت دقیق‌تر بر این بارداری‌ها اهمیت دارد، همچنین به نظر می‌رسد وجود PCOS در اهداکنندگان، بر میزان بارداری یا لانه‌گزینی و تعداد جنین‌های منتقل شده در برنامه‌های اهدای تخمک، تأثیر نمی‌گذارد؛ در نتیجه، زنان مبتلا به PCOS نباید از برنامه‌های اهدایی تخمک، خارج شوند.

کلیدواژه‌ها

موضوعات

زنان و زایمان

عنوان مقاله [English]

Outcomes and Challenges associated with In vitro Fertilization in Women with Polycystic Ovary Syndrome: A review study

نویسندگان [English]

Hadis Sourinejad ¹
Mitra Savabi Esfahani ²
Mohannad Javad Tarrahi ³
Elham Adib moghaddam ⁴

¹ PhD candidate in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

² Assistant Professor, Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

³ Associate Professor of Epidemiology and Biostatistics, Behavioral Sciences Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

⁴ PhD in Reproductive Health, Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Golestan University of Medical Sciences, Golestan, Iran

چکیده [English]

Introduction: Polycystic ovary syndrome (PCOS)is the most common endocrine disorder in women of childbearing age.There are many challenges regarding the quality of oocytes in these individuals.Therefore, this review study aimed to investigate the consequences and challenges associated with in vitro fertilization in women with polycystic ovary syndrome.
Materials and Methods: For related studies, the Persian SID and Magiran databases and Pubmed, Scopus, Elsevier, Weily online library, Sciences Web of Science databases and Google Scholar search engine were used for the period 1990–2019. To obtain all articles in Persian and English,the keywords of Polycystic ovarian syndrome, in vitro fertilization, Polycystic ovarian morphology, IVF outcome,Oocyte donation,Oocyte competence,Pregnancy,and their Persian equivalent are used separately or as possible combinations. From 450 articles, 17 were eligible and selected for this study.
Results: The results of various studies suggesting major challenges in this group of women including gonadotropins need and hormone-related changes, ovarian hyperstimulation syndrome (OHSS), clinical pregnancy rates, pregnancy outcomes and the risk of miscarriage, the quality of oocytes in women with polycystic ovary syndrome undergoing in vitro fertilization and the issue of egg donation in this group of women. However, fetal loss, clinical pregnancy and live birth rates are no different from other women.
Conclusion: Due to concerns about pregnancy in women with PCOS, closer monitoring of these pregnancies is important, it also appears that the presence of PCOS in donors does not affect the rate of pregnancy or implantation and the number of embryos transferred in ovarian donation programs. As a result, women with PCOS should not be excluded from egg donation programs.

کلیدواژه‌ها [English]

Polycystic ovary syndrome
in vitro fertilization
Pregnancy
Egg donation
in vitro fertilization outcomes

مراجع

[1]. Beydoun HA, Stadtmauer L, Beydoun MA, Russell H, Zhao Y, Oehninger S. Polycystic ovary syndrome, body mass index and outcomes of assisted reproductive technologies. Reproductive biomedicine online. 2009;18(6):856-63.

[2]. Rotterdam E, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and sterility. 2004;81(1):19.

[3]. Yildiz BO, Bozdag G, Yapici Z, Esinler I, Yarali H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Human reproduction. 2012;27(10):3067-73.

[4]. Joham AE, Teede HJ, Ranasinha S, Zoungas S, Boyle J. Prevalence of infertility and use of fertility treatment in women with polycystic ovary syndrome: data from a large community-based cohort study. Journal of women's health. 2015;24(4):299-307.

[5]. Sayehmiri F, Kiani F, Maleki F, Ahmadi M, Shohani M. Prevalence of polycystic ovary syndrome in Iranian women: a systematic review and meta-analysis. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2014;17(115):11-21.

[6]. Shoham Z, Weissman A. Polycystic ovarian disease: obesity and insulin resistance. 1998.

[7]. Edwards R, Beard HK. Is the success of human IVF more a matter of genetics and evolution than growing blastocysts? Human Reproduction. 1999;14(1):1-6.

[8]. Howles C, Macnamee M, Edwards R, Goswamy R, Steptoe P. Effect of high tonic levels of luteinising hormone on outcome of in-vitro fertilisation. The Lancet. 1986;328(8505):521-2.

[9]. Franks S, Roberts R, Hardy K. Gonadotrophin regimens and oocyte quality in women with polycystic ovaries. Reproductive BioMedicine Online. 2003;6(2):181-4.

[10]. Engmann L, Maconochie N, Sladkevicius P, Bekir J, Campbell S, Tan SL. The outcome of in-vitro fertilization treatment in women with sonographic evidence of polycystic ovarian morphology. Human Reproduction. 1999;14(1):167-71.

[11]. Järvelä IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Quantification of ovarian power Doppler signal with three-dimensional ultrasonography to predict response during in vitro fertilization. Obstetrics & Gynecology. 2003;102(4):816-22.

[12]. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility: lippincott Williams & wilkins; 2005.

[13]. Balasch J, Fábregues F, Creus M, Puerto B, Peñarrubia J, Vanrell JA. Follicular development and hormone concentrations following recombinant FSH administration for anovulation associated with polycystic ovarian syndrome: prospective, randomized comparison between low-dose step-up and modified step-down regimens. Human reproduction. 2001;16(4):652-6.

[14]. ESHRE T. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. 2008 Consensus on infertility treatment related to polycystic ovary syndrome Fertility and Sterility89. 2008:505-22.

[15]. Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. The Journal of Clinical Endocrinology & Metabolism. 2015;100(3):911-9.

[16]. Esmailzadeh S, Faramarzi M, Jorsarai G. Comparison of in vitro fertilization outcome in women with and without sonographic evidence of polycystic ovarian morphology. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2005;121(1):67-70.

[17]. Swanton A, Storey L, McVeigh E, Child T. IVF outcome in women with PCOS, PCO and normal ovarian morphology. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2010;149(1):68-71.

[18]. Dor J, Shulman A, Levran D, Ben-Rafael Z, Rudak E, Mashiach S. The treatment of patients with polycystic ovarian syndrome by in-vitro fertilization and embryo transfer: a comparison of results with those of patients with tubal infertility. Human Reproduction. 1990;5(7):816-8.

[19]. Heijnen E, Eijkemans M, Hughes E, Laven J, Macklon N, 3, Fauser B. A meta-analysis of outcomes of conventional IVF in women with polycystic ovary syndrome. Human reproduction update. 2005;12(1):13-21.

[20]. Boomsma CM EM, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12:673-83.

[21]. Tasali E VCE, Ehrmann DA. Polycystic ovary syndrome and obstructive sleep apnea. Sleep Med Clin. 2008;3:37-46.

[22]. Veltman-Verhulst SM BJ, Eijkemans MJ, Fauser BJ. Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies. Hum Reprod Update. 2012;18:638–51.

[23]. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International journal of surgery. 2014;12(12):1495-9.

[24]. Zhong Y-P, Ying Y, Wu H-T, Zhou C-Q, Xu Y-W, Wang Q, et al. Comparison of endocrine profile and in vitro fertilization outcome in patients with PCOS, ovulatory PCO, or normal ovaries. International journal of endocrinology. 2012;2012.

[25]. Sahu B, Ozturk O, Ranierri M, Serhal P. Comparison of oocyte quality and intracytoplasmic sperm injection outcome in women with isolated polycystic ovaries or polycystic ovarian syndrome. Archives of gynecology and obstetrics. 2008;277(3):239-44.

[26]. Cho M, Ambartsumyan G, Danzer H, Brennan K, Surrey M. The clinical ramifications of polycystic ovarian morphology in oocyte donors. Journal of assisted reproduction and genetics. 2013;30(2):233-8.

[27]. Li HWR, Lee VCY, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment. Journal of assisted reproduction and genetics. 2014;31(2):205-11.

[28]. Papanikolaou EG, Pozzobon C, Kolibianakis EM, Camus M, Tournaye H, Fatemi HM, et al. Incidence and prediction of ovarian hyperstimulation syndrome in women undergoing gonadotropin-releasing hormone antagonist in vitro fertilization cycles. Fertility and sterility. 2006;85(1):112-20.

[29]. Aboulghar M. Prediction of ovarian hyperstimulation syndrome (OHSS) Estradiol level has an important role in the prediction of OHSS. Human Reproduction. 2003;18(6):1140-1.

[30]. Kazemi A, Nasr-Esfahani MH, Ahmadi M, Bashardoost N. Comparison of outcome of assisted reproductive methods in patient with polycystic ovaries syndrome and tubal factor. Journal of Shahrekord Uuniversity of Medical Sciences. 2006;8.

[31]. Lu X, Yang X, Li M, Zhou F, Zhu Y, Huang H. Outcome of in vitro fertilization-embryo transfer in treatment of polycystic ovarian syndrome. Zhejiang da xue xue bao Yi xue ban= Journal of Zhejiang University Medical sciences. 2006;35(3):319-22.

[32]. 32. Sterling L, Liu J, Okun N, Sakhuja A, Sierra S, Greenblatt E. Pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization. Fertility and sterility. 2016;105(3):791-7. e2.

[33]. Wang X, Luan C, Zhang W, Hu S. Pregnancy outcomes of in vitro fertilization and embryo transfer in infertile women with polycystic ovarian syndrome. Zhonghua fu chan ke za zhi. 2012;47(10):730-3.

[34]. Palomba S, Daolio J, La Sala GB. Oocyte competence in women with polycystic ovary syndrome. Trends in Endocrinology & Metabolism. 2017;28(3):186-98.

[35]. Vaz GQ, Evangelista AV, Sartorio CAP, Cardoso MCA, Erthal MC, Gallo P, et al. Are patients with polycystic ovarian syndrome ideal candidates for oocyte donation? BioMed research international. 2016;2016.

[36]. Homburg R, Levy T, Berkovitz D, Farchi J, Feldberg D, Ashkenazi J, et al. Gonadotropin-releasing hormone agonist reduces the miscarriage rate for pregnancies achieved in women with polycystic ovarian syndrome. Fertility and sterility. 1993;59(3):527-31.

[37]. Legro RS. Pregnancy considerations in women with polycystic ovary syndrome. Clinical obstetrics and gynecology. 2007;50(1):295-304.

[38]. Gillham B. Research Interviewing: The range of techniques: A practical guide: McGraw-Hill Education (UK); 2005.

[39]. Aboulghar MA, Mansour RT, Serour GI, Ramzy AM, Amin YM. Oocyte quality in patients with severe ovarian hyperstimulation syndrome. Fertility and sterility. 1997;68(6):1017-21.

[40]. Niu Z, Lin N, Gu R, Sun Y, Feng Y. Associations between insulin resistance, free fatty acids, and oocyte quality in polycystic ovary syndrome during in vitro fertilization. The Journal of Clinical Endocrinology & Metabolism. 2014;99(11):E2269-E76.

[41]. Wong IL, Morris RS, Lobo RA, Paulson RJ, Sauer MV. Endocrinology: Isolated polycystic morphology in ovum donors predicts response to ovarian stimulation. Human Reproduction. 1995;10(3):524-8

مجله دانشگاه علوم پزشکی سبزوار

پیامدها و معضلات همراه با لقاح داخل آزمایشگاهی در زنان مبتلا به سندرم تخمدان پلی‌کیستیک: یک مطالعه مروری

مراجع

مراجع

دوره 28، شماره 3
مرداد و شهریور 1400
صفحه 359-371

پیامدها و معضلات همراه با لقاح داخل آزمایشگاهی در زنان مبتلا به سندرم تخمدان پلی‌کیستیک: یک مطالعه مروری

مراجع

مراجع

دوره 28، شماره 3مرداد و شهریور 1400صفحه 359-371

دوره 28، شماره 3
مرداد و شهریور 1400
صفحه 359-371