多囊卵巢综合征患者内分泌状态对其宫腔内人工授精成功率的影响  

Influence of endocrine status on the success rate of intrauterine insemination in patients with polycystic ovary syndrome

作　　者：刘盼[1] 郭丽娜[1] 赵敏英[1] LIU Pan;GUO LI-na;ZHAO Min-ying(Department of Reproductive Medicine,the First Hospital of Shijiazhuang,Hebei Province,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院生殖医学科,河北石家庄050011

出　　处：《河北医科大学学报》2018年第10期1185-1188,1192,共5页Journal of Hebei Medical University

基　　金：河北省科技计划项目(152777192)

摘　　要：目的评估多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者内分泌状态对其宫腔内人工授精(intrauterine insemination,IUI)成功率的影响。方法收集生殖医学科行夫精宫腔内人工授精助孕的PCOS患者的临床资料,共180个周期,按抗苗勒管激素(anti-Mullerian hormone,AMH)值高低分为3组,1组AMH值≤16.32pmol/L(第25百分位),2组>16.32~29.35pmol/L,3组AMH值>29.35pmol/L(第75百分位),比较各组的黄体生成素(luteinizing hormone,LH)、黄体生成素/卵泡刺激素(luteinizing hormone/follicle-stimulating hormone,LH/FSH)、睾酮(testosterone,T)值和妊娠率。结果 3组PCOS患者年龄、体重指数(body mass index,BMI)和不孕年限差异均无统计学意义(P>0.05)。2组和3组LH、LH/FSH、T值均高于1组,3组又高于2组,差异均有统计学意义(P<0.05)。PCOS患者AMH值与LH、LH/FSH、T值呈正相关(P<0.05)。1组妊娠率为24.4%,2组妊娠率为14.4%,3组妊娠率为8.9%,3组间妊娠率差异无统计学意义(P>0.05)。结论高AMH水平的PCOS患者,同时也存在高LH、T和LH/FSH。AMH水平对PCOS患者行IUI治疗的妊娠结局预测价值有限,但是其水平过高还是会降低妊娠率。Objective To evaluate the effect of endocrine status on success rate of intrauterine insemination（IUI）in patients with polycystic ovary syndrome（PCOS）.MethodsThe clinical data of polycystic ovary syndrome patients who was implemented intrauterine insemination by husband in reproductive medicine department were collected,with 180 cycles.It was divided into three groups according to the anti-mullerian hormone（AMH）value.In group 1,AMH values were equeal to or less than 16.32 pmol/L（25 th percentile）.In group 2,AMH values were more than 16.32 pmol/L,but equeal to or less than 29.35 pmol/L.In group 3,AMH values were more than 29.35 pmol/L（75 th percentile）.The value of luteinizing hormone（LH）,luteinizing hormone/follicle-stimulating hormone（LH/FSH）and testosterone（T）and pregnancy rate were compared in each group.Results There was no significant difference in age,body mass index（BMI）and infertility among the three groups（P〈0.05）.The values of LH,LH/FSH and T in group 2 and 3 were higher than those in group 1,and the values of LH,LH/FSH and T in group 3 were higher than those in group 2,the difference were all statistically significant（P〈0.05）.The AMH value of PCOS patients was positively correlated with the value of LH,LH/FSH and T.The pregnancy rate of group 1 was 24.4%.The pregnancy rate of group 2 was14.4%.The pregnancy rate of group 3 was 8.9%.There was no significant difference in the pregnancy rate among the three groups（P〈0.05）.Conclusion High AMH levels of PCOS patients also have high LH,T and LH/FSH.The level of AMH is limited in predicting the pregnancy outcome of PCOS patients treated with IUI,but its high level will reduce the pregnancy rate.

关 键 词：多囊卵巢综合征 授精 人工 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学]