三种促排卵方案用于多囊卵巢综合征患者促排卵效果

摘要

目的：评价三种促排卵方案对多囊卵巢综合征（PCOS）引起的不孕症患者的促排卵效果。方法 PCOS患者255例（313个周期），随机分为3组：来曲唑（LE）组，克罗米酚（CC）组和人绝经期促性腺激素（HMG）组，给予不同的促排卵方案，观察卵泡发育情况和排卵情况、子宫内膜厚度、促排卵后妊娠结局和并发症等。结果 LE和HMG组有较高的排卵率，显著高于CC组，排卵个数LE组显著低于HMG组和CC组。HCG日子宫内膜厚度CC组最薄，HMG组最厚。周期妊娠率LE组和HMG组高于CC组，未破裂卵泡黄素化综合征（LUFS）发生率，CC组显著高于LE组和HMG组；流产率、多胎率和OHSS率三组无显著差异，但在CC组和HMG组中均有多胎和OHSS发生。结论在PCOS患者的促排卵中，来曲唑促排卵由于对子宫内膜抑制不明显和单排卵倾向，排卵率和妊娠率较高，且并发症较少，值得临床推广应用。%Objective To investigate the effect of three different ovarian stimulation protocols in promoting ovulation in infertile women with polycystic ovarian syndrome(PCOS). Method 255 patients were subjected to three ovary stimulation protocols:letrozole(LE),clomiphene citrate (CC),human menopausal gonadotropin(HMG).The number of follicles,endometrial thickness,pregnancy rate per cycle were compared. Result The ovulation rate were significantly higher in LE and HMG group. the number of ruptured follicles were significantly lower in LE group;the endometrial thickness at time of HCG administration was significantly higher in patents of HMG group. Pregnancy rates were significantly higher in LE and HMG group,compaed with that in CC group. In CC group had higher incidence rate of luteinized unruptured folliclesyndrome(LUFS). The abortion rate,Multiple birth rate and OHSS rate were no significant difference in three group,but there were OHSS and multiple birth occurred in CC group and HMG group. Conclusion The letrozole in patients with PCOS is effective in ovulatoing,and tends to single-follicle development. letrozole showed better ovulation rate and pregnancy rate,while had fewer complication,should be applied extensively in clinic.