中文摘要：

目的 探讨二甲双胍对多囊卵巢综合征（PCOS）合并胰岛素抵抗（IR）的不孕患者行体外受精/卵细胞浆内单精子显微注射（IVF/ICSI）的临床结局以及对子宫内膜容受性的影响.方法 将80例需IVF/ICSI助孕的PCOS患者随机分为二甲双胍组（A组）和对照组（B组）,A组患者于月经或撤退性出血的2~5 d开始口服二甲双胍500 mg/次,3次/日,至取卵后第6天,B组不服用二甲双胍.观察比较两组患者辅助生殖的相关参数,同时采集A组和B组中因卵巢过度刺激倾向未移植患者的子宫内膜组织,分别为A1、B1组,应用Western blot检测同源框基因A10（HOXA10）和整合素β3（ITGB3）水平的表达.结果 A、B两组Gn天数及其总量、获卵数、正常受精率、优胚率及子宫内膜厚度差异均无统计学意义（P〉0.05）,A组临床妊娠率较B组显著增高（P〈0.05）,而HCG日雌二醇水平、周期取消率、流产率和卵巢过度刺激综合征（OHSS）发生率均显著降低（P〈0.05）;A1组患者子宫内膜HOXA10和ITGB3蛋白表达水平均高于B1组（P〈0.05）.结论 对于PCOS合并IR的不孕患者,二甲双胍治疗可以提高患者IVF/ICSI助孕时的临床妊娠率,降低流产率和OHSS发生率,并改善子宫内膜容受性.

英文摘要：

Objective To explore the influence of metformin on pregnancy outcomes and endometrial receptivity of polycystic ovary syndrome （PCOS） infertile women with insulin resistance （IR） undergoing in vitro fertilization/intracytoplasmic sperm injection （IVF/ICSI）.Methods PCOS patients who underwent IVF/ICSI were divided into metformin group （group A） and control group （group B）.Patients in group A received metformin with a dose of 500 mg tid from the second to fifth day of menstrual period or with drawal bleeding until the sixth day of ovum pick-up （OPU）, and no metformin was provided for group B.The reproductive parameters of group A and B were compared.Endometrial tissue were from PCOS patients who were cancelled for the high risk of ovarian hyperstimulation syndrome （OHSS） in IVF/ICSI.Endometrial tissue were divided into group A1（n=3） and B1 group （n=3）, and western blot was used to detect the expression of HOXA10 and ITGB3.Results There was no significant difference of two groups in the number of days of Gn and its total, number of oocytes retrieved, normal fertilization rate, excellent embryo rate and endometrial thickness （P〉0.05）.The clinical pregnancy rate of group A was significantly higher than that of group B（P〈0.05）.Meanwhile, the E2 level on HCG day, cycle cancellation rate, miscarriage rate and the incidence of OHSS in group A were significantly lower than that of group B （P〈0.05）.The levels of HOXA10 and ITGB3 expression in A1 group were significantly higher than that of B1 group （P〈0.05）.Conclusion For PCOS infertility patients with IR in IVF/ICSI, metformin pretreatment can improve clinical pregnancy rate, reduce abortion rate and OHSS incidence, and improve endometrial receptivity.