不同雄激素水平PCOS患者诱导排卵临床结局分析  

Analysis of clinical outcomes of ovulation induction in PCOS patients with different androgen levels

作　　者：郭丽娜[1] 张君 吕翠婷[1] 赵素英[1] 乜照燕[1] 张娜[1] 甄秀丽[1] 

机构地区：[1]河北医科大学第四医院,石家庄050011 [2]河北省赞皇县医院

出　　处：《现代妇产科进展》2011年第12期952-954,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨多囊卵巢综合征(PCOS)患者在不同雄激素水平下诱导排卵的临床妊娠结局。方法:PCOS合并不孕患者352例,根据诱导排卵前基础睾酮(T)水平分为4组:A组60例,基础T正常,直接诱导排卵;B组64例,基础T正常,但仍给予达英-35治疗3个周期后诱导排卵;C组120例,基础T升高,给予达英-35治疗3个周期,复查T正常后诱导排卵;D组108例,基础T升高,给予达英-35治疗3个周期,复查T仍高于正常水平,经患者知情同意后,诱导排卵。比较4组子宫内膜厚度、尿促性素(HMG)用量、周期排卵率、临床妊娠率、流产率的差异。结果:4组子宫内膜厚度、排卵周期临床妊娠率组间比较差异无统计学意义(P>0.05);A组HMG用量最多,周期排卵率、总临床妊娠率最低,与其它3组的差异均有统计学意义(P<0.01,P<0.01,P<0.05);B、C、D组间周期排卵率、总妊娠率比较差异无统计学意义(P>0.05)。A组早期流产率最高,但4组间比较差异无统计学意义(P>0.05)。结论:基础T水平正常的PCOS患者,诱导排卵前应用口服避孕药治疗可改善临床妊娠结局;口服避孕药治疗后T未降至正常水平,且有生育要求的PCOS患者可试行诱导排卵治疗。Objective：To investigate the clinical pregnancy outcomes of induced ovulation in PCOS patients with different androgen levels.Methods：352 PCOS patients with infertility were divided into 4 groups according to testosterone（T）level before induced ovulation：group A of 60 patients whose basal T were normal to directly induce ovulation;group B of 64 patients whose basal T were normal too were induced ovulation after 3 cycles of Diane-35 treatment;group C of 120 patients whose basal T were increased,after 3 cycles of Diane-35 treatment,the T were become normal and then induced ovulation;group D of 108 patients,whose basal T were increased,after 3 cycles of Diane-35 treatment,the T were still higher than normal,were induced ovulation after the patients permission.The endometrial thickness,human menopausal gonadotrophin（HMG）dosage,cycle ovulation rate,pregnancy rate and abortion rate were compared among the 4 groups.Results：There were no significant difference among 4 groups in the endometrial thickness and clinical pregnancy rate of ovulation cycle（P 0.05）.There were significant difference in group A with the highest HMG doses,lowest cycle ovulation rate and lowest total clinical pregnancy rate compared with the other 3 groups（P0.01,P0.01,P0.05）.There were no significant difference among the group B,group C,group D in cycle ovulation rate and the total pregnancy rate（P0.05）.The early abortion rate was the highest in group A,but there were no significant differences among 4 groups（P0.05）.Conclusions：Oral contraceptives treatment prior to induced ovulation,which may improve the clinical pregnancy outcome in PCOS patients with normal basal T levels.The PCOS patients who try to have a baby urgently can be given the treatment of induced ovulation although the levels of T are still higher than normal after oral contraceptives treatment.

关 键 词：多囊卵巢综合征 不孕 高雄激素血症 诱导排卵 临床妊娠率 

分 类 号：R711.75[医药卫生—妇产科学]