多囊卵巢综合征的促排卵治疗

TREATMENT OF INDUCTION OF OVULATION IN PCOS INFERTILE PATIENTS

目的：对比促排卵药对多囊卵巢综合征不孕症的治疗效果及对子宫内膜病理的影响。方法：B超监测45例病人接受克罗米酚（CC）、HMG或CC／HMG后卵泡的发育情况，观察用药前后子宫内膜的病理变化。结果：CC／HMG诱导排卵可获得40％的妊娠率且黄素化卵泡不破裂综合征及过度刺激综合征发生率低；用药前后子宫内膜增殖症的发生率有显著性差异（P＜0．05）。结论：CC失败者应用CC／HMG可取得满意疗效；促排卵药物可改善子宫内膜的病理状态，有助于子宫内膜癌的预防；黄体功能不全及间质发育不良可能是多囊卵巢综合征高排卵低妊娠率的原因之一。

Objective:To evaluate the effects of Clomiphene citrate (CC), HMG or CC/HMG on induction of ovulation and the change of endometrium pathology in PCOS infertile patients. Methods:Transvaginal ultrasound was used for monitoring ovulation of 45 patients who received the treatment ofCC, HMG or CC/HMG. The pathology change of endometrium biopsy was observed. Results: CC/HMG therapy has resulted in 40% pregnancy rate and low incidences of LUF and OHSS. There weresignificant differences in abnormal pathology of endometrium between pre-and post-treatment (P<0. 05). Conclusion:CC/HMG therapy is useful in patients with CC-resistant. Drug induction of ovulation can also reduce the abnormal endometrium hyperplysia and prevent the cancer of endometriumLPD and the deficiency in endometrial stroma development are the important reasons for inducing lowpregnancy rate but high ovulation rate.