不同促排卵法治疗多囊卵巢综合征伴不孕症患者的临床观察

Clinical analysis of different ovulation induction therapies for patients with polycystic ovarian syndrome related infertility

目的评估3种促排卵方法治疗多囊卵巢综合征（PCOS）合并不孕症的临床效果。方法将75例PCOS不孕症患者采用完全随机设计方法分为3组各25例，氯米芬（CC）组给予CC治疗；尿促性素（HMG）组给予HMG方案，CC＋HMG组给予CC＋HMG序贯治疗。观察3组排卵率、妊娠率及并发症情况。结果CC组、HMG组和CC＋HMG组排卵率分别为61．5％，87．7％，88．1％；妊娠率分别为24％，60％，56％：HMG组和CC＋HMG组与CC组相比排卵率及妊娠率均升高，差异有统计学意义（P〈0．05）。HMG组与CC＋HMG组排卵率、妊娠率比较无统计学意义（P〉0．05）；但多胎妊娠率及卵巢过度刺激综合征（OHSS）发生率比较，HMG组高于CC组和CC＋HMG组（P〈0．05）。结论采用HMG及CC＋HMG序贯方案优于CC的促排卵治疗，CC＋HMG方案保证妊娠率的同时可以降低多胎妊娠及OHSS的发生。

Objective To investigate the effects of three kinds of ovulation induction therapies for patients with Polycystic Ovarian Syndrome （ PCOS ） related infertility. Methods Seventy-five patients of PCOS related infertility were divided into three groups （ groupl, 2, 3 ） randomly. Patients in different groups were treated with Clomide（CC）, human menopasual gonadotropin （HMG）and CC ＋ HMG in sequential respectively. The ovulation rates, pregnancy rates and complications were analyzed. Results The ovulation rates were 61.5 % ,87.7% and 88. 1% in group 1,2,3. The pregnancy rates were 24% ,60% and 56% in group 1,2,3, with significant difference between group 1 and group 2 or 3 （P 〈 0.05）. There was no difference between group 2 and 3 in ovulation rates or pregnancy rates （ P 〉 0. 05 ）. There was difference of occurrence rates of Ovarian Hyperstimulation Syndrome （OHSS） and twins between group 2 and group 1 or 3 （ P 〈 0.05 ）. Conclusion HMG and CC ＋ HMG are better than CC ovulation induction therapies and CC might decrease the occurrence rates of OHSS and multiple pregnancy.