原发不孕与继发不孕超声监测排卵结果对比分析

Comparison of Follicular Development in Primary and Secondary Infertile Women

目的:探讨原发不孕与继发不孕超声监测排卵结果的差异。方法:回顾分析原发不孕组50例(A组)和继发不孕组50例(B组)各100个周期超声监测排卵结果。结果:两组卵巢体积(6.01±0.20 cm3,6.25±0.28 cm3)、优势卵泡直径(1.88±0.15 cm,2.05±0.11 cm)、月经周期第3天窦卵泡数(CD3-AFC)(6.12±1.02个,6.35±1.15个)、排卵期子宫内膜厚度(10.6±1.60 mm,9.36±1.65 mm),比较差异无统计学意义(P>0.05);两组无排卵周期率(15%,9%)、小卵泡排卵(SFO)率(10%,3%)、卵泡未破裂黄素化综合征(LUFS)(20%,3%)比较,A组明显高于B组(P<0.05);无排卵和小卵泡排卵患者卵巢体积和CD3-AFC明显小于排卵正常者。结论:原发不孕患者排卵障碍发生率高于继发不孕患者;小卵泡排卵和无排卵是排卵障碍的主要类型;多数继发不孕患者自然周期有排卵,使用促排卵药物应了解排卵情况,避免盲目使用,以减少医疗费用和促排卵治疗引起的各种不良后果。

Objective：To investigate the difference of the follicular developments between primary infertility and secondary infertility. Methods： 100 infertile women were retrospectively analyzed, with 50 cases in each primary and secondary group. Follicular developments were detected by transvaginal B-mode ultrasonography. Results. There were no differences between two groups in ovarian volume （6.01 ±0.20 cm^3 VS. 6.25±0.28 cm^3）, dominant follicle size（1.88± 0.15 cm VS. 2.05±0.11 cm）, CD3-AFC（6.12± 1 .02 versus 6.35±1.15）, endometrial thickness（10.6 ± 1.50 mm VS. 9.36±1.65mm）. The rates of anovulation, small follicular ovulation （SFO） and luteinized unruptured follicle syndrorne were significantly higher in primary infertile group. The ovarian volume and CD3-AFC were significantly smaller in anovulation or SFO patients. Conclusions： The rate of the abnormal follicular developments is higher in primary infertile women than that of secondary infertile women, most of which are anovulation or SFO. Follicular developments are normal in most secondary infertile women, and should be assessed before ovulation treatment.