脂代谢紊乱对多囊卵巢综合征不孕患者夫精宫腔内人工授精的影响  

Effect of polycystic ovary syndrome with dyslipidemia undergone intrauterine insemination

作　　者：司凡[1] 陈妍[1] 孙萌 陆宏燕 寇伟鑫[1] 许丽丽 SI Fan;CHEN Yan;SUN Meng;LU Hong-yan;KOU Wei-xin;XU Li-li(Department of Reproductive Medicine,Chengde Central Hospital;Department of Health Education,Chengde Center for Disease Control and Prenvention,Chengde 067000,Hebei,China)

机构地区：[1]承德市中心医院生殖医学科 [2]承德市疾病预防控制中心健康教育科,河北承德067000

出　　处：《川北医学院学报》2022年第3期333-335,344,共4页Journal of North Sichuan Medical College

基　　金：河北省承德市科技支撑计划项目(202102A004)。

摘　　要：目的:探讨脂代谢紊乱对多囊卵巢综合征(PCOS)不孕患者夫精宫腔内人工授精(IUI)的影响。方法:选取92对女方均为PCOS患者的不孕夫妇,接受夫精宫腔内人工授精174个周期后,根据脂代谢情况分为研究组(伴有血脂紊乱,n=95)和对照组(不伴血脂紊乱,n=79)。比较两组患者基线资料、助孕治疗过程及妊娠结局。结果:研究组患者身体质量指数(BMI)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、处理后前向运动精子总数高于对照组(P<0.05);促卵泡激素(FSH)水平低于对照组(P<0.05);HCG日子宫内膜厚度、A型内膜比例、多卵泡发育比例、排卵均高于对照组,但差异无统计学意义(P>0.05)。研究组的妊娠率低于对照组,异位妊娠率和流产率均高于对照组,随着血脂紊乱严重程度增加,临床妊娠率逐渐降低,但差异无统计学意义(P>0.05)。高胆固醇血症组、高低密度脂蛋白血症组妊娠率低于对照组,均具有显著差异(P<0.05)。结论:脂代谢紊乱对PCOS患者妊娠率有重要影响,尤其是合并高胆固醇血症或高低密度脂蛋白血症的PCOS患者妊娠率更低。Objective:To investigate the effect of dyslipidemia on intrauterine insemination(IUI)in infertile patients with polycystic ovary syndrome(PCOS).Methods:92 infertile couples with PCOS were selected.After 174 cycles of IUI,they were divided into study group(with dyslipidemia,n=95)and control group(without dyslipidemia,n=79)according to the lipid metabolism.The basic materials,the index during the process of assisted reproductive technology and pregnancy outcome were compare between the two groups.Results:The level of BMI,TG,TC,LDL,FBG,HOMA-IR and the total number of forward motile sperm in the study group were higher than those in the control group(P<0.05),the FSH level of the study group were lower than that of the control group(P<0.05).The endometrial thickness,the proportion of type a endometrium,the proportion of multiple follicles and ovulation in the study group on HCG day were higher than those in the control group,but the differences were not statistically significant(P>0.05).The pregnancy rate of the study group was lower than that of the control group,and the ectopic pregnancy rate and abortion rate were higher than those of the control group.The severer of dyslipidemia,the lower of clinical pregnancy rate(P>0.05).The pregnancy rate of hypercholesterolemia group and higher LDL group was lower than that of the control group(P<0.05).Conclusion:The dyslipidemia has an important impact on the pregnancy rate of PCOS patients,especially in PCOS patients with hypercholesterolemia or higher LDL.

关 键 词：宫腔内人工授精 脂代谢紊乱 妊娠率 

分 类 号：R711.6[医药卫生—妇产科学] R713.7[医药卫生—临床医学]