阿拉瑞林联合人绝经期促性腺激素治疗小卵泡排卵的疗效观察

Clinical efficacy of alarelin and human menopausal gonadotropin on small follicle ovulation

目的探讨阿拉瑞林联合人绝经期促性腺激素(HMG)治疗小卵泡排卵的临床价值。方法将小卵泡排卵148例692个周期随机分成3组,A组:同时使用阿拉瑞林及HMG B组:单纯使用HMG C组:先用克罗米酚,后用HMG。观察比较3组的肌注人绒毛膜促激素性腺(HCG)日最大卵泡平均直径及直径≥14 mm的卵泡个数、周期妊娠率、周期取消率、过早LH峰周期率、多胎率、OHSS周期发生率。结果HCG日最大卵泡平均直径(MFD)及直径≥14 mm的卵泡个数A组显著高于B组(P<0.05),A组妊娠率、多胎率、周期取消率以及OHSS周期发生率较B、C组显著增加而过早LH峰周期率显著下降(P<0.05)。结论阿拉瑞林联合HMG治疗小卵泡排卵临床效果显著,可提高妊娠率,但周期取消率、OHSS发生率、多胎率亦相应增加,临床应用应权衡利弊。

Aim To explore the clinical value of alarelin and human menopausal gonadotropin（HMG） on small follicle ovulation（SFO）. Methods 148 women with SFO of 692 cycles were divided into three groups randomly. One group was treated with alarelin and HMG, one with HMG, one with clomiphene and after with HMG. The media diameter of the biggest follicle （MFD） and numbers of follicle diam- eter〉~ 14 mm on HCG administration day, clinical pregnancy rates, cancellation rates, multiple pregnancy rates and ovarian hyperstimula- tion syndrome（OHSS） rates were compared among 3 groups. Results In group A the biggest follicle MFD and numbers of follicle diameter≥ 14 mm were significantly higher than those in group B（ P 〈 0. 05 ）. Clinical pregnancy rates, cancellation rates, multiple pregnancy rates and OHSS rates were significantly increased in group A than those in group B and C ,but luteotropic hormone（LH） rates were lower （ P 〈 0. 05 ）. Conclusion Clinical efficacy was remarkable of alarelin and HMG on SFO, but the complication was serious. So it should be carefully used with its advantages and disadvantages weighed.