左炔诺孕酮宫内节育系统在IVF中的应用:3例报道及文献复习  

Application of levonorgestrel intrauterine system in IVF:three cases report and literature review

作　　者：康佳晶 王素琴 王云燕 韩晓芳 杨敏[1] 梁梦瑶 李弘 Kang Jiajing;Wang Suqin;Wang Yunyan;Han Xiaofang;Yang Min;Liang Mengyao;Li Hong(Reproductive Medicine Center,the Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030000,China;Department of Gynecology,the Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第五临床医学院生殖医学科,太原030000 [2]山西医科大学第五临床医学院妇科,太原030000

出　　处：《中华生殖与避孕杂志》2023年第9期953-956,共4页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金青年科学基金项目(82101689)。

摘　　要：目的探讨左炔诺孕酮宫内节育系统在子宫内膜不典型增生和子宫腺肌病合并不孕患者行体外受精(in vitro fertilization,IVF)助孕中的疗效和使用特点。方法回顾性分析了2019年至2021年期间就诊于山西医科大学第五临床医学院生殖医学科的3例子宫内膜不典型增生及子宫腺肌病合并不孕患者的病例资料,所有患者均经过左炔诺孕酮宫内节育系统保守治疗成功后尽快采取了IVF助孕,采用了高孕激素状态下促排卵方案及促性腺激素释放激素拮抗剂促排卵方案,于冻融周期移植前取环。结果2例子宫内膜不典型增生均完全缓解,其中1例获得健康单活胎,1例生化妊娠;1例子宫腺肌病完全缓解,获得健康单活胎。结论左炔诺孕酮宫内节育系统治疗由子宫内膜不典型增生和子宫腺肌病引起的不孕症,可以达到更好的效果,可有效改善子宫内膜容受性。Objective To investigate the efficacy and characteristics of levonorgestrel intrauterine system in in vitro fertilization(IVF)assisted pregnancy for infertility patients with atypical endometrial hyperplasia and adenomyosis.Methods The clinical characteristics of 3 infertility patients with atypical endometrial hyperplasia and adenomyosis admitted to the Reproductive Medicine Center,the Fifth Clinical Medical College of Shanxi Medical University from 2019 to 2021 were retrospectively analyzed.All patients underwent IVF as soon as possible after the successful treatment of levonorgestrel intrauterine system.Using progestin-primed ovarian stimulation protocol and gonadotropin-releasing hormone antagonist protocol,the ring was removed before frozen-thawed transfer.Results Two cases of atypical endometrial hyperplasia were completely relieved,one case received healthy singleton fetus,and one case received biochemical pregnancy.One case had complete remission of adenomyosis and received healthy singleton fetus.Conclusion Levonorgestrel intrauterine system in the treatment of infertility caused by atypical endometrial hyperplasia and adenomyosis can not only achieve better therapeutic effect but also effectively improve endometrial receptivity.

关 键 词：受精 体外 子宫腺肌病 左炔诺孕酮宫内节育系统 子宫内膜不典型增生 子宫内膜容受性 

分 类 号：R714.8[医药卫生—妇产科学]