评估减重对多囊卵巢综合征患者宫腔内人工授精成功率的影响  

The Effect of Weight Loss on the Success Rate of Intrauterine Insemination in Patients with Polycystic Ovary Syndrome

作　　者：刘盼[1] 赵敏英[1] 郭丽娜[1] 孙晓慧[1] 王素改[1] LIU Pan;ZHAO Min-ying;GUO Li-na;SUN Xiao-hui;WANG Su-gai(Department of Reproductive Medicine,First Hospital of Shijiazhuang City,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院生殖医学科,050011

出　　处：《国际生殖健康／计划生育杂志》2018年第4期273-276,296,共5页Journal of International Reproductive Health/Family Planning

基　　金：河北省科技计划项目(152777192)

摘　　要：目的:评估减重对多囊卵巢综合征(PCOS)患者宫腔内人工授精(IUI)成功率的影响。方法:收集2013年1月—2017年6月于河北省石家庄市第一医院生殖医学科行夫精IUI(IUI-H)助孕的PCOS患者的完整临床资料,其中体质量指数(BMI)≥24 kg/m^2者共180例336个周期,按预处理方式,将患者分为减重组、药物组和无预处理组(对照组),其中减重组按减重比例分为5%≤减重<10%组(减重1组)、10%≤减重<20%组(减重2组)和减重≥20%组(减重3组),比较各组的激素水平变化以及妊娠率和流产率。结果:4组LH差值、LH/FSH差值和T差值差异均有统计学意义(P<0.01);减重1组、减重2组、减重3组的LH差值、LH/FSH差值和T差值逐渐升高,差异有统计学意义(P<0.05);药物组的LH差值和T差值小于减重3组,但均高于减重1组、减重2组(P<0.05);药物组的LH/FSH差值与减重3组差异无统计学意义,但高于减重1组和减重2组(P<0.05)。减重2组、减重3组、药物组的妊娠率均高于对照组和减重1组,差异有统计学意义(P<0.05);对照组与减重1组比较,差异无统计学意义(P>0.05);减重2组、减重3组、药物组的妊娠率比较,差异无统计学意义(P>0.05)。减重3组、药物组的流产率低于对照组和减重1组,差异有统计学意义(P<0.05);减重2组、减重3组、药物组的流产率比较,差异无统计学意义(P>0.05)。结论:对于肥胖型PCOS患者来说,随着减重比例增加,LH、LH/FSH和T值的降低幅度也相应增加;减重10%以上时促排卵后行IUI治疗的妊娠率明显提高,而流产率的显著降低则需要至少减重20%。Objective：To assess the effect of weight loss on the success rate of intrauterine insemination（IUI） in patients with polycystic ovary syndrome（PCOS）. Methods： The clinical data of PCOS patients undergoing IUI-husband semen treatment were collected between January 2013 and June 2017 in our hospital. Among them,180 patients with body mass index（BMI） greater than or equal to 24 kg/m^2 had a total of 336 cycles. According to the pretreatment, patients were divided into the weight loss group, the drug group and the no-preconditioning group（control group）. The weight loss group was divided into three subgroups according to the weight loss ratio：5%≤weight loss10% as the subgroup 1, 10%≤weight loss20% as the subgroup 2, and weight loss ≥20% as the subgroup 3. The levels of hormones, the pregnancy rate and the abortion rate were compared. Results： The difference of LH, LH/FSH and T difference between the four groups were statistically significant（P〈0.01）. The LH difference, LH/FSH difference and T difference in the subgroup 1, the subgroup 2 and subgroup 3 increased gradually, and the difference were statistically significant（P〈0.05）. The LH difference and T difference in the drug group were less than the subgroup 3, but higher than the subgroup 1 and subgroup 2（P〈0.05）. There was no significant difference in the LH/FSH difference between the drug group and the subgroup 3, but the LH/FSH difference in the drug group was higher than that in the subgroup 1 and subgroup 2（P〈0.05）. The pregnancy rates in the subgroup 2,the subgroup 3 and the drug group were significantly higher than that in the control group and the subgroup 1（P〈0.05）. There was no statistical difference in the pregnancy rate between the subgroup 2, the subgroup 3 and the drug group（P〈0.05）. The abortion rates in the subgroup 3 and the drug group were significantly lower than those in the control group and the subgroup 1（P〈0.05）. There was no significant difference in the abortion rate be

关 键 词：预处理 体重减轻 多囊卵巢综合征 宫腔内人工授精 授精 人工(丈夫供体) 妊娠率 流产 

分 类 号：R711.75[医药卫生—妇产科学] R714.8[医药卫生—临床医学]