多囊卵巢综合征患者使用重组人促卵泡激素联合人工受精治疗的临床多中心研究  

Low-dose recombinant FSH step-up ovarian stimulation and intrauterine insemination for women with polycystic ovary syndrome-A multicenter clinical study

作　　者：刘金勇 王媁 刘嘉茵 丁卫 

机构地区：[1]南京医科大学第一附属医院生殖医学科,江苏省210029

出　　处：《江苏医药》2014年第8期896-899,共4页Jiangsu Medical Journal

基　　金：国家973项目(2012CB944703);江苏省科技厅临床医学科技专项(BL2012009);高校优势学科项目(PAPD)

摘　　要：目的回顾性分析全国多中心低剂量重组人促卵泡刺激素(rFSH)递增方案诱导排卵联合宫腔内人工受精(IUI)在多囊卵巢综合征(PCOS)患者中使用的临床结果,探索卵巢反应预测因子。方法总结2009年11月-2011年6月20家医院生殖中心251个IUI周期,总结临床结局,分析卵巢反应预测因子。结果 (1)临床妊娠率为20.72%(52/251);双胎率9.62%(5/52);三胎率1.92%(1/52);流产率21.15%(11/52)。参与IUI患者无卵巢过度刺激综合征(OHSS)发生。单卵泡发育率68.53%(172/251)。(2)单卵泡发育率与基线FSH水平正相关(OR=1.27,95%CI为1.01-1.59,P<0.05)。(3)37.5IU启动剂量组多卵泡发育率较75.0IU剂量组低(P<0.05)。(4)高体重指数(BMI)妇女的阈剂量大于低BMI者(P<0.05)。结论低启动剂量可以获得较高的单卵泡发育率,减少并发症。单卵泡发育可能与基础FSH正相关。Objective To evaluate the clinical outcomes in women with polycystic ovary syndrome treated with low-dose recombinant follicle-stimulating hormone （FSH） step-up ovarian stimulation and intrauterine insemination（IUI） and investigate the predictors for ovarian responses. Methods The 251 IUI cycles and clinical outcomes in the reproductive centers of 20 hospitals from 2009,Nov. to 2011, Jun. were summarized and the predictors for ovarian responses were analysed. Results The incidence rates of pregnancy, twins,multiple and abortion were 20.72%, 9.62%, 1. 92 and 21.15%, respectively. Mono-follicular development was positively correlated to the level of FSH （OR = 1.27, 95%CI： 1.01-1.59, P〈0. 05）. The multi-follicular development rate was significantly lower with a start dose of 37.5 IU than that with 75.0 IU（P〈0. 05）. The women with a higher body mass index（BMI） had a higher threshold dosages（P〈0. 05）. Conclusion Low dose recombinant FSH protocols is better for women with polycystic ovary syndrome to get mono-follicular development with less complications. Mono-follicular development may positively correlated with basic FSH level.

关 键 词：多囊卵巢综合征 重组人促卵泡刺激素 人工受精 

分 类 号：R715[医药卫生—妇产科学]