卵泡期经阴道小卵泡穿刺抽吸术治疗多囊卵巢综合征排卵障碍  

Transvaginal follicular aspiration in follicle phase in the management of anovulation associated with polycystic ovary syndrome

作　　者：朱文杰[1] 李雪梅[1] 陈秀敏[1] 张黎[1] 

机构地区：[1]深圳市妇幼保健院生殖健康科,518028

出　　处：《中华妇产科杂志》2003年第11期685-688,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨对克罗米芬治疗无反应的多囊卵巢综合征患者在卵泡期经阴道小卵泡穿刺抽吸术后 ,使用促性腺激素诱发排卵时卵泡的发育及其结局。方法　选择 17例对克罗米芬治疗无反应 ,或对促性腺激素治疗发生卵巢过度刺激或无反应 ,但输卵管通畅、男方精液正常的多囊卵巢综合征不孕患者 ,在月经 (人工周期 )第 5天给予促性腺激素治疗 ,给药 5d后 ,在B超指引下经阴道行小卵泡穿刺抽吸术 ,双侧卵巢仅留 1～ 2个较大卵泡 ,术后继续给予促性腺激素 ,观察卵泡发育、排卵和妊娠情况及血中性激素水平变化。结果　 17例中除 2例 (11 8% )对该治疗方法无反应外 ,15例出现优势卵泡发育和排卵 ,其中单卵泡发育 9例 (5 2 9% ) ,双卵泡发育 4例 (2 3 5 % ) ,3卵泡发育 2例(11 8% ) ,发育的优势卵泡全部排卵。总共有 7例妊娠 ,全部为单胎妊娠 ,单周期治疗妊娠率 4 1 2 %(7/ 17)。结论　卵泡期经阴道小卵泡穿刺抽吸术能使对克罗米芬治疗无反应的多囊卵巢综合征不孕患者 ,使用促性腺激素治疗获得良好的单卵泡发育和单胎妊娠率。Objective To investigate the follicle development and pregnancy in clomiphene citrate-resistant patients with polycystic ovary syndrome (PCOS) after transvaginal follicular aspiration and gonadotropin administration. Methods Seventeen clomiphene citrate-resistant patients with PCOS failed to gonadotropin treatment associated with ovarian hyperstimulation syndrone(OHSS). They are anovulatory infertility with normal tubal and husbands'sperm condition. In this treatment regimen,all patients was administered with gonadotropin from day 5 of menstrual cycle(or withdrawal bleeding) and were asked to undergo ultrasound-guided transvaginal follicular aspirations for 5 days later. Only one or two follicles for every ovary were remained and gonadotropin administration was continued. A follicle development,ovulation rate,pregnancy rate and sex hormone were monitored. Results Fifteen of the 17 patients experienced dominant follicles development and ovulation. 9 of them with one(52.9%) ,4 with two(23.5%) and 2 with three(11.8%) dominant follicles ovulated and pregnancy occurred in 7 patiends(41.2%). All of pregnancy are singleton. Conclusion A single follicle development and singleton pregnancy can be realized in clomiphene citrate-resistant PCOS patients by combined ultrasound-guided transvaginal follicular asperation with gonadotropin administration.

关 键 词：卵泡期 经阴道小卵泡穿刺抽吸术 治疗 多囊卵巢综合征 排卵障碍 促性腺激素 

分 类 号：R711.75[医药卫生—妇产科学]