不同促排卵方案对供精人工授精多囊卵巢综合征患者的疗效分析  

Efficacy of different ovulation induction protocols in patients with polycystic ovary syndrome undergoing artificial insemination with donor sperm

作　　者：张清健 宋革 姜荣华 刘晓玲 祝晓丽 詹泽虎 蔡晓林 李艳 Zhang Qingjian;Song Ge;Jiang Ronghua;Liu Xiaoling;Zhu Xiaoli;Zhan Zehu;Cai Xiaolin;Li Yan(Key Laboratory of Male Reproduction and Genetics of National Health Commission,Reproductive Center of Guangdong Provincial Reproductive Science Institute,Guangzhou Guangdong 510600,P.R.China)

机构地区：[1]国家卫生健康委员会男性生殖与遗传重点实验室,广东省生殖科学研究所生殖中心,广东广州510600

出　　处：《中国计划生育和妇产科》2023年第10期69-72,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：广东省医学科研基金项目(项目编号:A2022326)。

摘　　要：目的探讨不同促排卵方案对供精人工授精(artificial insemination with donor sperm,AID)多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者生育结局的影响。方法回顾性分析2011年1月至2020年12月期间在广东省生殖医院生殖中心治疗的191例PCOS患者(240个AID治疗周期)。根据患者采用的促排卵药物将其分为3组,其中枸橼酸氯米芬(clomiphene citrate,CC)组92例、促性腺激素(gonadotropin,Gn)组53例以及来曲唑(letrozole,LE)组46例,比较3组优势卵泡数、优势卵泡大小、子宫内膜厚度、子宫内膜形态、临床妊娠率、活产率、流产率和多胎妊娠率。结果(1)Gn组的子宫内膜厚度、优势卵泡数[(10.85±1.68)mm、(1.70±1.21)]优于CC组[(9.84±1.62)mm、(1.31±0.53)]和LE组[(9.92±1.47)mm、(1.16±0.37)](P<0.05);(2)3组间的优势卵泡大小、子宫内膜形态、临床妊娠率、活产率、流产率和多胎妊娠率差异均无统计学意义(P>0.05),有2例多胎源于Gn组;(3)LE组的单个优势卵泡率[84.21%(48/57)]高于CC组[69.05%(87/126)]和Gn组[59.65%(34/57)],差异有统计学意义(P<0.05)。结论在AID中,PCOS患者采用CC、Gn和LE治疗,妊娠结局同样有效;为了降低多胎率,可推荐LE促排卵治疗。Objective To explore the effect of different ovulation induction protocols on fertility outcomes in patients with polycystic ovary syndrome(PCOS)undergoing artificial insemination with donor sperm(AID).Methods A total of 240 AID cycles in 191 PCOS patients were analyzed from January 2011 to December 2020 in Reproductive Center of Guangdong Provincial Fertility Hospital.According to ovulation induction drugs used,the patients were divided into 3 groups,including 92 cases of clomiphene citrate(CC)group,53 cases of gonadotropin(Gn)group and 46 cases of letrozole(LE)group.And the number of dominant follicles,predominant follicle size,endometrial thickness,endometrial morphology,clinical pregnancy rates,live birth rates,abortion rates and multiple pregnancy rates were compared among three groups.Results(1)Both endometrial thickness and the number of predominant follicles in Gn group[(10.85±1.68)mm,(1.70±1.21)]were significantly higher than those in CC group[(9.84±1.62)mm,(1.31±0.53)]and LE group[(9.92±1.47)mm,(1.16±0.37)](P<0.05);(2)There was no significant difference in the size of dominant follicles,endometrial morphology,clinical pregnancy rate,live birth rate,abortion rate and multiple pregnancy rate among the three groups(P>0.05),and two multiple fetuses originated from Gn group;(3)The single dominant follicle rate in the LE group[84.21%(48/57)]was significantly higher than that in CC group[69.05%(87/126)]and Gn group[59.65%(34/57)](P<0.05).Conclusion In women with PCOS undergoing AID stimulated with CC,LE and Gn were equally effective.To reduce the multiple pregnancy rate,LE ovulation promotion therapy can be recommended.

关 键 词：多囊卵巢综合征 供精人工授精 广义估计线性方程 

分 类 号：R711.6[医药卫生—妇产科学]