预测卵巢储备能力54例分析  

Predictive Value of Clomiphene Cifrate Challenge Test for Ovarian Reserve(Analysis of 54 cases)

作　　者：胡祥秀 王瑾蔚[1] 裴海萍 包秋萍 

机构地区：[1]上海市黄浦区中心医院妇产科,200002

出　　处：《中国实用妇科与产科杂志》1999年第12期729-731,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨不孕症患者采用克罗米芬（ＣＣ） 兴奋试验，预测卵巢储备能力。方法　通过５４ 例不孕症妇女月经第３ 天测定血卵泡刺激素（ＦＳＨ）、雌二醇（Ｅ２）水平，月经第５～９ 天口服ＣＣ１００ｍｇ／ｄ，第１０ 天再次测定ＦＳＨ、Ｅ２ ，Ｂ超跟踪监测卵泡发育及妊娠情况。结果　３５ 岁以上和以下两组患者基础ＦＳＨ、ＣＣ兴奋试验和妊娠率均有显著差异。年龄越大，基础ＦＳＨ值越高，ＣＣ兴奋试验反应率越低，妊娠率越低。本组５４ 例采用改良ＣＣ兴奋试验有反应３６ 例，反应不良１８ 例，分别采用ＣＣ、ＣＣ／ｈＭＧ、ｈＭＧ、ＦＳＨ 促排卵，共８６ 个周期，妊娠１４ 例，周期妊娠率分别为１６－６７％ 、１２－５０ ％ 、４０ ％ 、１００ ％ 。结论　采用改良ＣＣ 兴奋试验预测卵巢储备能力有更高的筛选价值，并指导卵巢有控制性过度刺激（ＣＯＨ）方案的选择，有效提高妊娠率。Objective\ To study the predictve value for ovarian reserve modified clomiphene cifrate challenge test(CC test)was carried out in infertile patients.Methods\ Serum follicle stimulating hormone(FSH)、estradiol(E 2)levels in 54 infertile patients were tested at the third day of menses.CC 100mg daily from day 5 to 9 was administered.Day 10 FSH and E 2 were measured again,dominant follicles and pregnancy rates were analysed.Results\ The results of the test were compared between two groups (ages≤35 and ages >35).Basal FSH levels,reactive rates of CC test and pregnant rates were significant differentb etween these two groups.The older the patient,the higher the basal FSH level,the lower the reactive rate of the CC test and the lower the pregnant rate.Among infertile patients,the CC test were reactive in 36 patients and 18 were poor reactive.We performed 86 ovulation induction cycles with CC、CC/hMG、hMG、FSH,which resulted in 14 pregnancies.Pregnant rate per cycle was 16.67%、22.73%、40%、100%respectively.Conclusion\ Modified CC test can predict the ovarian reserve and direct the choice of method for controlled ovarian hyperstimulation (COH)to improve pregnant rate.

关 键 词：卵巢储备 基础卵泡刺激素 不育症 COH CC 

分 类 号：R711.6[医药卫生—妇产科学]