小剂量雌激素及阿司匹林对促排卵中增殖期子宫内膜的影响

摘要

目的 探讨小剂量雌激素(戊酸雌二醇)及阿司匹林对氯米芬诱导排卵中增殖期子宫内膜的影响.方法 将60例不孕症患者按随机数字表法分为四组:自然周期组、氯米芬组(C组)、氯米芬+雌激素组(CE组)、氯米芬+雌激素+阿司匹林组(CEA组),每组各15例.观察四组增殖晚期子宫内膜厚度、子宫内膜类型、子宫动脉血流阻力指数(RI).结果 C组子宫内膜厚度明显比其他三组薄,增殖晚期子宫内膜厚度≥8mm率、A型子宫内膜率也明显低于其他三组(P<0.05);CE组A型子宫内膜率低于自然周期组和CEA组(P<0.05).C组、CE组和CEA组成熟卵泡直径≥15mm的卵泡数量[分别为(1.56±0.64)、(1.52±0.70)、(1.61±0.67)个]高于自然周期组[(1.01±0.25)个](P<0.05).子宫动脉血流砒Cc组(0.93±0.07)和CE组(0.95±0.04)显著大于自然周期组(0.81±0.05)和CEA组(0.83±0.03)(P<0.05).结论 小剂量雌激素能改善氯米芬诱导排卵中子宫内膜的发育,与小剂量阿司匹林合用时,通过增加子宫血流灌注,从而改善子宫内膜的容受状态.%Objective To assess the effect of clomiphene citrate(CC)on the proliferative stage of endometrium by the addition of low-doge estrogen(progynova,PGV)and aspirin.Methods Sixty women with unexplained infertility were divided into 4 groups randomly.Untreated group,CC treated group(C group),CC+PGV treated group(CE group)and CC+PGV+aspirin treated group(CEA group),each group Was 15 cases.Endometrium thickness,pattern of endometrium and resistant index(RI)of uterine artery were detected by ultrasound,all at end proliferative stage of endometrium.Results The endometrium thickness,the rate of the endometrium thickness≥8 mm and the rate of A-endometrium in C group were significantly less than those in other 3 groups(P<0.05).The rate of A-endometrium in CE group was significantly less than that in untreated group and CEA group(P<0.05).The number of follicle diameter≥15 mm in untreated group(1.01±0.25)was signifieantly less than that in other 3 groups(1.56±0.64,1.52±0.70,1.61±0.67)(P<0.os).RI of uterine artery in C group(0.93±0.07)and CE group(0.95±0.04)were significantly higher than that in untreated group(0.81±0.05)and CEA group(0.83±0.03)(P<0.05).Conclusion Low-dese estrogen can reverse the deleterious effect of CC on.endometrial development,and low-dose estrogen and aspirin can promote uterine perfusion and improve uterine compatibility.