妈富隆治疗耐氯米芬多囊卵巢综合征不孕的临床观察  

Clinical observation on the effect of mawelon on infertility in women with Clomipheneresistant polycystic ovary syndrome

作　　者：孙静[1] 齐国华[1] 熊晓英[1] 王颖[1] 李敏[1] 

机构地区：[1]深圳市蛇口人民医院,广东深圳518067

出　　处：《中国热带医学》2007年第9期1604-1605,1626,共3页China Tropical Medicine

摘　　要：目的观察妈富隆联合延长氯米芬(CC)服药时间或妈富隆联合低剂量FSH-HP开始促排卵方案治疗耐CC多囊卵巢综合征(PCOS)不孕的临床效果。方法选择耐CC的PCOS伴不孕的患者32例,73个治疗周期,随机分为2组。A组:妈富隆+CC组,16例,38个周期;B组:妈富隆+FSH-HP组,16例,35个周期。全部患者先用妈富隆治疗2个月并测定治疗前后血清性激素、卵巢体积和窦卵泡数。然后连续促排卵治疗3个周期,停药后比较A组和B组的周期排卵率、妊娠率、卵巢过度刺激综合征(OHSS)发生率和多胎率以及流产率。结果妈富隆治疗后血清LH、FSH、LH/FSH、T、E2、PRL水平,双侧卵巢体积、窦卵泡个数均较治疗前明显下降(P<0.01)。A组和B组周期排卵率分别为81.6%和91.4%、周期妊娠率分别为31.6%和42.9%、周期OHSS发生率分别为7.9%和2.9%、流产率分别为16.7%和13.4%、多胎率分别为16.7%和6.7%,A组和B组各相应的率间比较,差异均无统计学意义(P>0.05)。结论对耐CC的PCOS不孕患者,先行妈富隆前期治疗再用延长CC服药时间或低剂量FSH-HP开始促排卵治疗均能提高卵巢对促排卵的反应性,可以获得较高排卵率、妊娠率和较低OHSS、多胎妊娠的发生率,均是有效的促排卵方案。Objective To observe the clinical effects of marvelon combined with extended clomiphene citrate （CC） or marvelon combined with low dosage FSH - HP （metrodin - HP） on infertile women with clomiphene - resistant to polycystic ovary syndrome （PCOS）. Methods There 32 infertile women with CC - resistant to PCOS were randomly divided into group A consisted of 16 cases and treated with marvelon plus CC for 38 cycles Group B consisted of 16 cases and treated with marvelon plus FSH - HP aldo for 35 cycles. Before given ovulation induction drugs, all women were treated with marvelon for 2 months and the level of sexual hormone, ovary size and the ovary antral follicle counts before and after therapy were determined. Ovulation was induced after 3 induction cycles, the rates of ovudation per cycle, pregnancy per cycle, OHSS occurrence per cycle, multipregnancy and abortion were determined and analysed. Results The levels of serum LH, LH/FSH, T,E2, PRL, bilateral overy sizes and antral follicle counts were significantly increased （P 〈 0.01 ）, The ovulation rates, pregnancy rates, OHSS occurrence rates per cycle, abortion rates and multipregnancy rates in group A and B were 81.6% v.s. 91.4%, 31.6% v.s. 2.9%, 7.9% v.s. 2.9%, 16.7% v. s. 13.4% and 16.7% v.s. 6.7%, respectively, without showing signilican difference bewtween group A and B （P 〉 0.05）. Conclusion Pretreatment with marvelon followed by treament with extended CC or low dosage FSH - HP is a effective ovulation induction protocol for treatment of infertile women with CC - resistant to PCOS. It can not only improve the ovarian response to ovulation induction but also induce higher ovulation, thus enhanc the pregnant rate, reduce OHSS and multlpregnancy occurrence rate.

关 键 词：妈富隆 氯米芬抵抗 多囊卵巢综合征 

分 类 号：R711.75[医药卫生—妇产科学]