口服妈富隆并延长氯米芬用药时间治疗耐氯米芬的无排卵患者

Marvelon with Extended Clomiphene Citrate for the Treatment of Chronic Anovulation Resistant to CC Alone

目的评价常规服用氯米芬促排卵失败的妇女口服避孕药妈富隆配合延长氯米芬服用时间促排卵的治疗效果。方法114例患者在采用传统方法促排卵连续3个周期失败后,改服妈富隆2个周期以上。自停药后月经第5天开始服用氯米芬(50mg/d)促排卵,阴道B超(TVS)监测记录卵泡生长,至出现优势卵泡停服。B超监测排卵经过以及子宫内膜厚度的变化。结果114例患者在服用氯米芬5天后有37例出现优势卵泡,35例成功排卵,2例出现卵泡黄素化未破裂综合征(LUFS);延长服药时间后又有34例成功排卵,17例出现LUFS,13例出现卵泡发育,但未形成优势卵泡即闭锁;13例无卵泡发育。结论对于耐氯米芬的无排卵患者口服妈富隆联合延长氯米芬服药时间,是一种有效的促排卵方案。

Objective: To evaluate the effectiveness of extended clomiphene citrate(CC) with Marvelon(Ethinylestradiol/Desogestrel) for women who had failed to ovulate with conventional CC regimen. Method: 114 patients who had failed to ovulate with 3 cycles of traditional methods switched to Marvelon for at least two cycles. Then on 5th day of withdrawal of Marvelon, CC is taken 50mg/d, until the super-follicle is observed. Ovulation and thickness of endometrium were surveyed with transvaginal ultrasound (TVS). Results: In these 114 patients, 37 had super-follicle after taking CC for five days, among whom, 35 ovulated and 2 developed Luteinized Unruptured Follicle syndrome(LUFS). With extended CC therapy, 34 more patients ovulated ,,and 17 more had LUFS. 13 patients suffered from follicle atresia before the formation of super-follicle,while another 13 patients' follicle failed to developed at all. Conclusion:Anovulatory patients resistant to CC alone, have high rates of ovulation after treatment with extend CC and Marvelon.