多囊卵巢综合征患者不孕症治疗方法选择  

Consensus on Infertility Treatment Related to Polycystic Ovary Syndrome

作　　者：刘逸超[1] 杨英[1] 李威[1] 匡洪颖[1] 侯丽辉[1] 吴效科[1] 

机构地区：[1]黑龙江中医药大学附属第一医院妇产科,哈尔滨150040

出　　处：《国际生殖健康／计划生育杂志》2010年第3期243-246,共4页Journal of International Reproductive Health/Family Planning

摘　　要：多囊卵巢综合征(PCOS)患者不孕症治疗仍存在诸多争议。多数研究认为,药物治疗前,通过禁烟、禁酒和体育锻炼减轻体质量,调整患者既往不良生活方式对治疗非常有效。临床推荐一线治疗方法是抗雌激素类药物——氯米芬诱发排卵。氯米芬诱发后不能排卵者推荐采用二线方法,即服用外源性促性腺激素类药物或腹腔镜卵巢打孔术(LOS),但存在相应不良反应。临床推荐三线治疗是体外受精(IVF)。糖耐量受损的PCOS患者尚需应用胰岛素增敏药物联合其他疗法,因其临床剂量尚不明确,应用要严格慎重。芳香化酶抑制剂治疗效果好,致畸率低,但目前无法确定其临床治疗剂量。The treatment of infertile women with polycystic ovary syndrome （PCOS） is surrounded by many controversies. Before any intervention is initiated, preconceptional counseling should be provided emphasizing the importance of lifestyle, especially weight reduction and exercise in overweight women, smoking, and alcohol consumption. The recommended first-line treatment for ovulation induction remains the anti-estrogen clomiphene citrate （CC）. Recommended second-line intervention, should CC fail to resnh in pregnancy, is either exogenous gonadotropins or laparoscopic ovarian surgery （LOS）. The use of recommended second-line interventions are associated with adverse reactions. Recommended third-line treatment is in vitro fertilization（IVF）. Insulin-sensitizing agents in PCOS should be restricted to women with glucose intolerance. Based on recent data available in the literature, the routine use of this drug in ovulation induction is not recommended. Aromatase inhibitors are the anti-estrogen, which are good for PCOS women, and the malformation rate is low. Insufficient evidence is currently available to recommend the clinical use of aromatase inhibitors for routine ovulation induction.

关 键 词：多囊卵巢综合征 不孕症 治疗 

分 类 号：R711.75[医药卫生—妇产科学] R711.6[医药卫生—临床医学]