宫腔内配子移植治疗不明原因不孕的临床分析

Clinical analysis of gamete intrauterine transfer in treatment of unidentified reason infertility

目的了解宫腔内配子移植(GIUT)治疗不明原因不孕患者的疗效。方法采用尿促卵泡素(商品名:丽申宝,珠海丽珠医药,每支75U)控制下超促排卵,阴道B超及尿促黄体生成素(LH)峰监测卵泡生长情况,当有1个以上卵泡直径≥18mm或2个以上卵泡直径≥17mm、尿LH弱阳性或阴性时,给予肌注绒毛膜促性腺激素(HCG)1万单位,36h后取卵实施宫腔内配子移植;若尿LH强阳性,则于肌注HCG1万单位24h后实施宫腔内配子移植。结果18例GIUT中,临床妊娠6例,妊娠率33.3%。2例双胎,4例单胎。1例单胎患者孕56天发现胚胎停止发育,行清宫术。1例双胎、2例单胎已分娩,婴儿健康,余仍在妊娠中。未发生卵巢过度刺激综合征(OHSS)。结论GIUT治疗不明原因不孕患者有一定疗效,且程序简化,价格相对低廉,值得基层推广应用。

Objective： To evaluate the clinical effects of gamete intrauterine transfer （GIUT） in the treatment of unidentified reason infertility . Methods： Montoring the growth of follicle by Urofollitropin For Injection controlling ovarian hyperstimulation （COH）, transvaginal B ultrasound and urinary luteinizing hormone （LH） surge. When the number of follicle was ≥ 1 and their diameter ≥18mm, or the number of follicle was ≥2 and their diameter≥ 17mm, 10000IU HCG was injected immediately, then if the urinary LH surge was （± or - ）, 36 hours after HCG administration, GIUT was performed. If urinary LH surge was （ ＋ ）, 24 hours after HCG administration, GIUT was performed. Results： The clinical pregnancy rate was 33.3% , and there were no ovarian hyperstimulation syndrome （OHSS） in the 18 cycles GLUT. Conclusion ： The GIUT was useful in treatment of unidentified reason infertility with obvious effects, process simple and more inexpensive.