不同超促排卵方案对多囊卵巢综合征患者子宫内膜容受性及妊娠结局的影响  

Effects of Different Super-ovulation Regimens on Endometrial Receptivity and Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome

作　　者：黄绍敏 许淑芬 HUANG Shaomin;XU Shufen(Department of Reproductive Medicine,the First Affiliated Hospital of Xiamen University,Xiamen 361100,China;不详)

机构地区：[1]厦门大学附属第一医院生殖医学科,福建厦门361100

出　　处：《中国医学创新》2024年第36期142-147,共6页Medical Innovation of China

摘　　要：目的:探讨不同超促排卵方案对多囊卵巢综合征(PCOS)患者子宫内膜容受性及妊娠结局的影响。方法:回顾性分析2021年3月—2024年3月厦门大学附属第一医院收治的PCOS患者195例,根据超促排卵方案不同将患者分为A组(n=50,采用拮抗剂方案)、B组(n=87,采用黄体期长方案)、C组(n=58,采用改良超长方案),比较三组促排卵情况,子宫内膜容受性指标,胚胎情况及妊娠结局。结果:B组、C组促性腺激素(Gn)使用剂量及使用天数均高于A组(P<0.05);三组扳机日卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E2)水平比较,差异均无统计学意义(P>0.05)。治疗后,三组子宫内膜厚度、子宫内膜容积及子宫内膜血流量均高于治疗前,且B组、C组各项指标均高于A组(P<0.05),但治疗后B组、C组各项指标比较,差异均无统计学意义(P>0.05)。三组获卵总数、可移植胚胎数、优质胚胎数及临床妊娠率、早期流产率比较,差异均无统计学意义(P>0.05)。结论:不同超促排卵方案治疗PCOS患者均有助于提高卵子质量,达到较好的妊娠结局;其中黄体期长方案、改良超长方案在改善子宫内膜受容性方面更具优势,而拮抗剂方案能减少Gn使用剂量及时间。Objective:To investigate the effects of different super-ovulation regimens on endometrial receptivity and pregnancy outcomes in patients with polycystic ovary syndrome(PCOS).Method:A retrospective analysis was performed on 195 patients with PCOS admitted to the First Affiliated Hospital of Xiamen University from March 2021 to March 2024.According to different super-ovulation regimens,the patients were divided into group A(n=50,using antagonist regimens),group B(n=87,using luteal phase length regimens),and group C(n=58,using improved ultra-long regimens).Ovulation induction,endometrial receptivity,embryo status and pregnancy outcome were compared among the three groups.Result:The dosage and days of gonadotropin(Gn)in group B and group C were higher than those in group A(P<0.05).There were no significant differences in the levels of folliclestimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)among the three groups on trigger day(P>0.05).After treatment,the endometrial thickness,endometrial volume,and endometrial blood flow of the three groups were higher than those before treatment,and the indexes of group B and group C were higher than those of group A(P<0.05).However,after treatment,there were no statistical significance in indexes between group B and group C(P>0.05).There were no significant differences in the total number of eggs obtained,the number of transferable embryos,the number of high-quality embryos,the clinical pregnancy rate and the early abortion rate among the three groups(P>0.05).Conclusion:Different superovulation regimens can improve ovum quality and achieve better pregnancy outcome in PCOS patients.Among them,luteal phase long regimen and modified ultralong regimen have more advantages in improving endometrial receptibility,while antagonist regimen can reduce the dosage and time of Gn.

关 键 词：多囊卵巢综合征 妊娠 排卵诱导 超促排卵方案 子宫内膜容受性 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学]