摘要
目的探讨超声下未成熟卵泡抽吸术(IMFA)对多囊卵巢综合征(PCOS)不孕患者卵巢窦卵泡计数及其内分泌功能的影响;观察IMFA后,应用人绝经期促性腺激素(hMG)促排卵治疗的效果、妊娠及并发症情况.方法将71例PCOS不孕患者随机分为两组.组Ⅰ: 37例,穿刺前用少量hMG促排卵; 组Ⅱ: 34例,不用任何促排卵药物.在阴道超声引导下进行IMFA,检查穿刺后第2个周期患者的内分泌功能和卵巢基础窦卵泡计数,可连续2～3个周期进行穿刺.随后2组均用hMG常规促排卵治疗,随访其排卵及妊娠情况.结果组Ⅰ进行了88个周期的穿刺治疗,经过2～3次穿刺后,睾酮水平、黄体生成素(LH )与卵泡刺激素(FSH)的比值均明显降低,与治疗前比较,差异有统计学意义 (P<0.01),33例(89%,33/38)患者基础窦卵泡计数降至10个/卵巢以下.组Ⅱ进行了87个周期治疗,所有患者睾酮水平均显著降低,与治疗前比较,差异有统计学意义 (P<0.01); 30例LH/FSH<2, 28例(82%,28/34)患者基础窦卵泡计数降到10个/卵巢以下.在IMFA之后, 诱发排卵时hMG用量组Ⅰ为(21±6)支,组Ⅱ(23±10)支,两组比较,差异无统计学意义 (P>0.05),在注射人绒毛膜促性腺激素(hCG)后均出现排卵, 组Ⅱ有2例发生轻度卵巢过度刺激综合征(OHSS).连续促排卵治疗1～3个月后, 共36例(51%)患者获得妊娠.结论 IMFA能减少PCOS患者卵巢基础窦卵泡计数,并改善其内分泌状况,降低hMG促排卵周期中OHSS的发生率,为PCOS不孕患者提供了又一有效可行的辅助生育治疗途径.
Objective To investigate the effect of ultrasound-guided immature follicle aspiration (IMFA) on polycystic ovarian syndrome (PCOS) in women with anovulatory infertility, such as the endocrinology of the patients and the basic follicles number in the ovaries, and to observe the ovarian response to human menopausal gonadotropin (hMG) stimulation and pregnancy after the therapy. Methods Seventy-one PCOS patients were involved in this trial, and divided into 2 groups. Thirty-seven patients of group Ⅰ were primed with slight amount of hMG, the other 34 patients did not use hMG. Ultrasound-guided IMFA was performed 36 hour after human chorionic gonadotropin(hCG) administration. In the next cycle, the basal endocrinology and the basic number of follicles were checked, then IMFA were performed continuously until the basic number of follicles were under 10 per ovary. Afterwards, hMG were used to stimulate ovulation and the pregnant results were followed up. Results There were 37 cases (88 cycles) of PCOS patients in group Ⅰ and 34 cases (87 cycles) in group Ⅱ. After 2 to 3 treatment cycles, the testosterone level became normal in all of patients. The basic follicle number decreased to less than 10 per ovary in 33 cases (89%) in group I and 28 cases (82%) in group Ⅱ. After hCG stimulation, all of them ovulated. Only 2 patients developed slight ovarian hyperstimulation syndrome (OHSS). Within 3 months after the procedure, 36 patients (51%) became pregnant by controlled ovarian hyperstimulation (COH) protocol after IMFA. Conclusions Immature follicle aspiration treatment can improve the abnormal endocrinology, decrease the basic follicle number of the ovary, and achieve pregnancy in following COH cycles, meanwhile, avoid OHSS in PCOS patients.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2005年第5期295-298,共4页
Chinese Journal of Obstetrics and Gynecology
基金
山东省中青年科学家奖励基金资助项目(2000BD2CAA1)
