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대한생식의학회지 제26권 제3호 2010년
체외수정시술을 위한 과배란유도시 난소낭종의 크기에 따른 임상적 반응에 대한 연구
중앙대학교 의과대학 산부인과학교실
이용석, 이상훈, 김동호, 배도환, 허민,
A Study on Clinical Response to Controlled Ovarian Hyperstimulation of In Vitro Fertilization and Embryo transfer according to the Size of Baseline Ovarian Cyst
Lee ys, Lee sh, Kim dh, Bae dh, Hur m
Objective ; This study was performed to compare the clinical response to controlled ovarian hyperstimulation(COH) of in vitro fertilization and embryo transfer(IVF-ET) according to the size of baseline ovarian cyst. Method ; From February 1992 to March 1999, a retrospective analysis was done of 272 cases who underwent COH using mid-luteal phase long protocol of gonadotropin-releasing hormone agonist (GnRH-a) for IVF-ET. These cases were divided into four group; group 1(n=63) had cysts with mean diameters between 20.0 and 29.0mm on their baseline ultrasound on cycle day 3, group 2(n=57, 30.0-49.0mm), group 3(n=68, >50.0mm) and control group(n=84). Cases were excluded according to the following criteria; pure male factor infertility, the presence of only one ovary, high CA-125 level and previous endometriosis. Results ; There were no statistically significant differences between cases with baseline ovarian cyst <50.0mm in diameter and control group in any of the parameters. However, cases with baseline ovarian cyst>50.0mm in mean diameter needed more amount of human menopausal gonadotropin(hMG), showed significantly lower estradiol(E2) level, the number of follicle>15.0mm on the day of human chorionic gonadotropin(hCG) administration, the number of oocytes retrieved, the number of mature oocytes, and pregnancy rate compared with control group. Conclusion ; This study suggests that cases with baseline ovarian cyst <50.0mm in diameter do not adversely impact on IVF-ET outcome. However, cases with baseline ovarian cyst >50.0mm in diameter had adverse effects on various parameters. Therefore, to improve the outcome of IVF-ET in these cases, ovarian cyst aspiration prior to initiating COH may be required.
키워드 : In vitro fertilization and embryo transfer(IVF-ET), Controlled ovarian hyperstimulation(COH), ovar
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