延迟启动促性腺激素促排卵时间改善PCOS患者的妊娠率

Enhancement of gestation rate of POCS patients by delaying the time of ovulation induction with gonadotropins

目的寻找多囊卵巢综合症患者更为有效、易于实施且价廉的促排卵方法。方法传统地于月经第5d给促性腺激素促排卵未孕的PCOS患者64例于下一个周期将促性腺激素的给药时间延迟到月经第10—14d，对比获得妊娠周期与上一个未孕周期血清E2、P及LH在HCG注射日的水平，同时对比两个周期中大、中、小卵泡数量及子宫内膜的厚度。结果妊娠周期HCG日E2及P的水平均低于未妊娠周期（P〈0．05）；而LH水平在两个周期中差异无统计学意义（P〉0．05）。妊娠周期中小卵泡的数量低于未妊娠周期（P〈0．05）；子宫内膜厚度差异无统计学意义（P〉0．05）。64例PCOS患者中32例在延迟启动促排卵周期获得妊娠，周期妊娠率51．61％。结论延迟促性腺激素促排卵的启动时间通过减少募集卵泡数，降低E2及P水平，不增加早发LH峰的风险从而增加子宫内膜接受性，PCOS患者的妊娠率因此得到改善。

Objective To look for more effective ,easy and cheap ovulation induction protocol. Methods 64 PCOS - related infertility female patient failed with HMG ovulation induction starting at cycle day 5 treated for vulation induction delay at next cycle of from day 10 to day 14. The levels of serum E2, P, LH, the count of different diameter follicles and the thickness of endometrium at HCG day were analyzed. Results The level of serum E2, P and the count of small follicles were lower in successful pregnancy cycle than that of failed cycle （P〈0.05） .There was no significant difference in LH levels between two cycles. Thirty-two out of 64 women were ingested with a pregnancy rate of 51.60%. Conclusion Delay the starting time of ovulation induction though reduction of the number of follicles and the level of serum E2 and P without incresing risk of LH enhancement, and the acceptability of endometrium and pregnancy rate can be improved.