78例多囊卵巢综合征患者不同促卵排卵方案的疗效分析

Effects of Different Ovulation-inducing Treatments in Ininfertile Women with Polycystic Ovary Syndrome

目的探讨多囊卵巢综合征患者不同促排卵方案的疗效。方法选择2007年1月1日～2008年10月30日在临沂市妇幼保健院生殖中心门诊就诊的78例多囊卵巢综合征患者,把78例患者随机分为三组:氯米芬(CC)组,尿促素(HMG)组,来曲唑(LZ)组。所有患者均于月经第5天或黄体酮撤退性出血的第5天,拟行促排卵治疗并指导同房。观察三组患者的排卵率及周期妊娠率。结果三组的排卵率无显著性差异(P>0.05);周期妊娠率:来曲组与HMG组均高于CC组(P<0.01),来曲唑组与HMG组周期妊娠率无显著性差异(P>0.05),子宫内膜厚度LZ组厚于CC组,但中、重卵巢过度刺激综合征(OHSS)发生率来曲唑组低于HMG组。结论来曲唑用于多囊卵巢综合征的不孕症妇女,具有良好的排卵率及妊娠率,又能减少卵巢过度刺激综合征发生的风险。

Objective To investigate the effects of different ovulation-inducing treatments in ininfertile women with polycystic ovary syndrome （PCOS）. Methods Seventy -eight cases of PCOS were analyzed in our hospital from Jan.2000 to Jan. 2006,and they were divided into three groups：CC group,HMC group and LZ group. Ovulation was induced by using 50mg/day CC administered daily from the fifth day of the mentrual cycle or 75 IU /day HMG or 5mg/day LZ. From the tenth day, Ultrasound was performed to monitor follicle development.When the diameter of the biggest follicle reached ≥ 18mm, 10 000IU HCG was injected to trigger ovulation,and ovulation rate and pregnancy rate were observed. Results Thel~ was no significant difference in the ovulation rate of three groups （P 〉 0.05）. The pregnancy rate was higher in HMC group and LZ group than that in CC group（P〈0.01）. There was no significant difference in the pregnancy rate between LZ and HMC groups（P〉0.05）. The thickness of endometrinm in the LZ group was much thicker than that in CC group（P〈0.01 ）. The OHSS incidence of LZ group was lower than that in CC group. Conclusion Letrozole can obtain good ovulation rate and pregnancy rate in PCOS infertile women,with less danger in OHSS.