炔雌醇环丙孕酮片联合二甲双胍治疗多囊卵巢综合征105例疗效观察

Cyproterone Ethinyl Estradiol Tablet Combined with Metformin in the Treatment of Polycystic Ovarian Syndrome (PCOS):Analysis of 105 Cases

目的对排卵障碍的多囊卵巢综合征(PCOS)患者在进行体外受精-胚胎移植(IVF-ET)之前使用炔雌醇环丙孕酮片(达英-35)和二甲双胍进行预处理,探讨并分析预处理对妊娠结局和卵巢过度刺激(OHSS)发生率的影响。方法回顾性分析我中心205例PCOS患者,其中85例患者使用达英-35和二甲双胍联合治疗(处理组A),78例患者单用达英-35治疗(处理组B),42例患者未用药(对照组C)。结果 A组与B组临床妊娠率和OHSS发生率无明显差异(P>0.05),A组与C组、B组与C组之间妊娠率和OHSS发生率均有明显差异(P<0.05),且A组与C组的差异性更显著(P<0.01)。结论 IVF-ET促排卵前对患者进行预处理是有必要的,特别是联合使用二甲双胍可显著增加PCOS患者的临床妊娠率,降低OHSS的发生率。

Objective Polyeystic ovarian syndrome （PCOS） patients with ovulation disorder were pretreated with cyproterone ethinyl estradiol tablet （Diane-35） and metformin before in vitro fertilization and embryo transfer（ IVF- ET） to evaluate the effect of different preconditioned treatment on the pregnancy outcome and incidence rate of ovarian hyperstimulation syndrome（OHSS）. Methords A total of 205 patients with PCOS in our center were retrospectively analyzed ,of whom 85 bad Diane -35 combined with metformin （group A） , and 78 had Diane -35 solely （group B） , and 42 had no preconditioned treatment （group C）. Results No significant difference （P 〉 0.05） in clinic pregnancy and incidence rate of OHSS was found between group A and B. A significant difference （ P 〈 0.05 ） in clinic pregnancy and incidence risk of OHSS was existed between group A and group B, group A and group C, and the difference between group A and C was more significant（P 〈0.01 ）. Conclusion Preconditioned treatment prior to ovulation induction in patients is necessary in IVF- ET, expecially preconditioning of metformin can significantly increase the clinic pregnancy rate and reduce the incidence risk of OHSS in the patients with PCOS.