甲状腺癌术后合并多囊卵巢综合征患者的促排卵方案  

Ovulation promotion plan of patients with PCOS after thyroid cancer surgery

作　　者：李静[1] 王志红[1] 李艳[1] Li Jing;Wang Zhihong;Li Yan(Department of Reproductive Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院生殖医学部,450000

出　　处：《中国实用医刊》2021年第14期16-18,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨甲状腺癌术后合并多囊卵巢综合征(PCOS)患者的促排卵方案。方法抽取2016年10月至2020年10月于郑州大学第二附属医院行促排卵治疗的甲状腺癌术后合并PCOS的患者40例,按照随机数字表法分为来曲唑组(20例)和氯米芬组(20例)。来曲唑组(LE组)从月经第5天给予LE 2.5 mg/d口服,连用5 d。月经第10天根据卵泡发育情况酌情加用尿促性素注射剂(HMG)75~150 IU至HCG日;氯米芬组(CC组)从月经第5天给予氯米芬50 mg/d口服,连用5 d。第10天根据卵泡发育情况酌情加用HMG 75~150 IU至HCG日。阴道超声下了解卵泡发育情况,当至少一个卵泡直径≥18 mm时,肌肉注射HCG 10000 IU诱发排卵。分别记录当最大卵泡直径达14 mm时和HCG日双侧卵巢内直径≥10 mm的卵泡数目和血中雌二醇(E2)水平以及两组妊娠率。结果最大卵泡直径达14 mm时和HCG日,LE组血中E2水平和直径≥10 mm卵泡数目均低于CC组(P<0.05);LE组妊娠比例(6/20)高于CC组(4/20),但差异未见统计学意义(P>0.05)。结论对于甲状腺癌术后合并PCOS且需要促排卵治疗的女性患者,建议首选来曲唑做为一线促排卵药物。Objective To explore the ovulation induction program for patients with polycystic ovary syndrome(PCOS)after thyroid cancer surgery.Methods Forty patients with PCOS after operation of thyroid cancer in the Second Affiliated Hospital of Zhengzhou University from October 2016 to October 2020 were divided into letrozo group(n=20)and clomiphene group(n=20)according to random number table method.Letrozo group(LE group)was given oral letrozole 2.5 mg/d from the 5th day of menstruation for 5 days.On the 10th day of menstruation,human menopausal gonadotropin(HMG)75-150 IU was added to HCG day according to follicular development.clomiphene group(CC group)was given clomiphene 50 mg/d orally from the 5th day of menstruation for 5 days.On the 10th day,HMG 75-150 IU was added to HCG day according to follicular development.When the diameter of at least one follicle was more than 18 mm,HCG 10000 IU was injected intramuscularly to induce ovulation.The number of follicles with diameter of more than or equal to 10 mm in both ovaries,the level of estradiol(E2)in blood and the pregnancy rate of the two groups were recorded when the maximum follicle diameter was 14 mm and on the day of HCG.Results The level of E2 and the number of follicles with diameter more than or equal to 10 mm in LE group were lower than those in CC group when the largest follicle diameter reached 14 mm and on HCG day(P<0.05);The pregnancy ratio of LE group(6/20)was higher than that of CC group(4/20),but the difference was not statistically significant.Conclusions Letrozole is recommended as the first-line ovulation induction drug for female patients with PCOS after thyroid cancer surgery.

关 键 词：甲状腺癌 不孕症 促排卵 来曲唑 

分 类 号：R711.75[医药卫生—妇产科学] R736.1[医药卫生—临床医学]