戊酸雌二醇与阿司匹林联合应用对诱发排卵周期子宫内膜发育及临床妊娠率的影响

Study of the effects of progynova along with aspirin on endometrial development and clinical pregnancy rate in ovulation induction cycle

目的:观察戊酸雌二醇与阿司匹林联合应用对氯米芬(CC)促排卵周期子宫内膜发育及临床妊娠率的影响。方法:对75例原因不明性排卵障碍的病人进行前瞻性研究。根据随机应用不同的药物分为氯米芬组(Ⅰ组),氯米芬+阿司匹林组(Ⅱ组),氯米芬+阿司匹林+补佳乐组(Ⅲ组),每组25例,同时选取25例因男方因素就诊,排卵正常的不孕妇女为对照组。观察三组病人HCG日子宫内膜厚度、子宫内膜类型、子宫动脉搏动指数(PI)、子宫动脉血流阻力指数(RI);排卵后7d子宫内膜厚度、孕酮(P)水平、PI、RI及临床妊娠率。结果:Ⅰ组病人HCG日子宫内膜厚度、A型内膜所占比例和黄体中期子宫内膜厚度显著低于对照组,而PI值、RI值显著高于对照组;Ⅱ组和Ⅲ组病人HCG日子宫内膜厚度、A型内膜所占比例、排卵后7d子宫内膜厚度显著高于Ⅰ组,PI值和RI值低于Ⅰ组;Ⅲ组排卵后7dP水平、临床妊娠率显著高于Ⅰ组和Ⅱ组。结论:戊酸雌二醇与阿司匹林联合应用可以改善氯米芬促排卵引起的子宫内膜发育不良,有助于提高临床妊娠率。

Objective：To study the effects of progynova along with aspirin on endometrial development and clinical pregnancy rate in ovulation induction cycle. Methods： A prospective study involved total 75 patients as observation group with unexplained anovulation problems was performed. The observation group was divided inte 3 groups randomly, which were treated with clomiphene citrate （CC）only, 03 added with aspirin, and CC added aspirin along with progynova respectively. Endometrial thickness, echogenic pattern of the endometrial and pulsatility index（PI） and resistant index（RI） of uterine artery as well as Progesterone （P） and cilinieal pregnancy rate were determined. Results： All endometrial thickness on hCG day and the 7th day after ouvlation as well as A-type echogenic rate of group Ⅰ were lower than that of control group, and PI and RI were higher than that of the control group. Endometrial thickness on hCG day and the 7th day after ouvlation and A-type echogenic rate of group Ⅱ and group Ⅲ were higher than that of group Ⅰ , PI and RI were lower than that of group Ⅰ .Progesterone on the 7th day after ovulation and cilinieal pregnancy rate of group Ⅲ were higher than that of group Ⅰ and group Ⅱ Conlusion： Progynova along with aspirin may reverse the side effects of CC on endometrial development and increase clinical pregnancy rate.